Chronic hepatitis B management in six South Australian Aboriginal community controlled health services
Michael Larkin A B * , Mohammad Mahmood A C , James Ward D , Beth Hummerston B , David Johnson B and Caroline Laurence AA The University of Adelaide, Public Health, 57 North Terrace, Adelaide, SA 5000, Australia.
B Aboriginal Health Council of South Australia, 220 Franklin Street, Adelaide, SA 5000, Australia.
C Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
D The University of Queensland, Poche Centre for Indigenous Health, 31 Upland Road, St Lucia, Qld 4067, Australia.
Australian Journal of Primary Health 28(6) 508-513 https://doi.org/10.1071/PY21272
Submitted: 27 February 2022 Accepted: 1 August 2022 Published: 12 September 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University
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.
Keywords: Aboriginal, Aboriginal community controlled health services, chronic disease management, comprehensive care, continuity of care, healthcare quality, hepatitis B, primary health care.
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