Chronic hepatitis B management in six South Australian Aboriginal community controlled health services

Abstract

Background Chronic hepatitis B is a significant public health issue; however, there is limited understanding of the engagement in primary health care of Aboriginal people living with chronic hepatitis B (CHB). Methods To better understand the management of CHB, diagnostic reports and case note audits were conducted in six South Australian Aboriginal community controlled health services. The audits covered the initial assessment, CHB monitoring, and hepatocellular carcinoma screening. The initial assessment was reviewed by auditing client clinical records for the first 12 months from the date of diagnosis, whereas CHB monitoring and hepatocellular carcinoma screening were determined by auditing a 12-month sample period (January to December 2019). Associations with CHB monitoring were determined using a Chi-squared test and Fisher’s exact test P-values, as appropriate. Results There were 50 current clients with a diagnosis of CHB at the time of the audit (January 2020). Testing was incomplete for the initial assessment, CHB monitoring and hepatocellular carcinoma screening. There were significant associations between the increased likelihood of accessing monitoring and the number of times a person attended an Aboriginal community controlled health service, accessing care in a more remote region, having a documented recall and having a GP management plan containing CHB. Conclusion Through providing evidence of significant associations between having a recall set and GP management plans with increased uptake of disease monitoring, this study has highlighted areas for improvement in clinical management.