Moussa Dina, Flores Joan Ericka, Doyle Joseph S, Ryan Marno, Wallace Jack, Howell Jessica
University of Melbourne, Australia.
St Vincent's Hospital Melbourne, Australia.
PLoS One. 2025 Jan 10;20(1):e0313216. doi: 10.1371/journal.pone.0313216. eCollection 2025.
BACKGROUND & AIMS: This systematic literature review of qualitative findings aims to identify the perceived barriers and enablers for hepatocellular carcinoma (HCC) surveillance from patient and clinician perspectives.
A systematic search of databases using key term combinations with the following inclusion criteria: 1) qualitative and quantitative (survey) studies exploring barriers and enablers of HCC surveillance, and 2) qualitative and quantitative (survey) studies exploring barriers and enablers of enagagement in clinical care for patients with cirrhosis and/or viral hepatitis.
The search returned 445 citations: 371 did not meet the study criteria and were excluded. 74 studies proceeded to full-text review, leading to 21 included studies (15 studies from searching with a further six studies from citation review) progressing to data extraction by two independent reviewers. Results from studies exploring patients' perspectives reinforce that barriers are experienced by patients across different health settings, cultures, and regions. Logistical barriers including costs and transportation, and knowledge/awareness barriers were commonly identified. Studies that included clinician perspectives highlighted the need for healthcare provider education and system-level interventions to optimize HCC surveillance uptake in clinical practice.
These findings highlight the critical need for interventions that enable engagement in HCC surveillance in health services.
本项对定性研究结果的系统文献综述旨在从患者和临床医生的角度确定肝细胞癌（HCC）监测中存在的感知障碍和促进因素。
使用关键词组合对数据库进行系统检索，纳入标准如下：1）探索HCC监测障碍和促进因素的定性和定量（调查）研究，以及2）探索肝硬化和/或病毒性肝炎患者临床护理参与障碍和促进因素的定性和定量（调查）研究。
检索共返回445条引文：371条不符合研究标准被排除。74项研究进入全文审查，最终21项研究（检索得到15项研究，引文审查又得到6项研究）由两名独立审查员进行数据提取。探索患者观点的研究结果强化了这样的观点，即不同健康环境、文化和地区的患者都面临障碍。常见的障碍包括后勤方面的障碍，如成本和交通，以及知识/意识方面的障碍。纳入临床医生观点的研究强调，需要对医疗服务提供者进行教育，并采取系统层面的干预措施，以优化临床实践中HCC监测的应用。
这些发现凸显了在卫生服务中开展促进HCC监测参与的干预措施的迫切需求。
