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The cascade of care for Australians living with chronic hepatitis B: measuring access to diagnosis, management and treatment.
Aust N Z J Public Health. 2015 Jun; 39(3):255-9.AN

Abstract

OBJECTIVE

To estimate the level of access to diagnosis, management and treatment for people living with chronic hepatitis B (CHB) in Australia, and to identify the gaps in clinical care for people living with CHB.

METHODS

Analysis of publicly available population level data including infectious disease notifications, Medicare and Pharmaceutical Benefits Scheme utilisation data, census-based estimates of CHB prevalence and burden, and mathematical modelling.

RESULTS

In 2012, of the estimated 218,567 Australians living with CHB, 57% had been diagnosed, 17,367 people (8%) received recommended HBV DNA viral load testing (without treatment) and 10,987 (5%) received antiviral therapy.

CONCLUSIONS

This analysis reveals substantial gaps in the cascade of care for CHB in Australia, most notably in diagnosis (with 43% undiagnosed) and in recommended yearly monitoring (87% not in care). The number receiving therapy represents only one-third of those estimated to require treatment to prevent progressive liver disease and liver cancer.

IMPLICATIONS

These findings demonstrate that the majority of those affected are not receiving guideline-based care; highlight the need for improvements in opportunistic screening, engagement in care, and access to therapy; and provide a method to assess the impact of public health and clinical interventions in response to CHB over time.

Authors+Show Affiliations

Epidemiology Unit VIDRL, The Doherty Institute, Victoria. Department of Medicine, University of Melbourne, Victoria.Epidemiology Unit VIDRL, The Doherty Institute, Victoria. Department of Medicine, University of Melbourne, Victoria.Epidemiology Unit VIDRL, The Doherty Institute, Victoria. Department of Medicine, University of Melbourne, Victoria.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25716519

Citation

Allard, Nicole L., et al. "The Cascade of Care for Australians Living With Chronic Hepatitis B: Measuring Access to Diagnosis, Management and Treatment." Australian and New Zealand Journal of Public Health, vol. 39, no. 3, 2015, pp. 255-9.
Allard NL, MacLachlan JH, Cowie BC. The cascade of care for Australians living with chronic hepatitis B: measuring access to diagnosis, management and treatment. Aust N Z J Public Health. 2015;39(3):255-9.
Allard, N. L., MacLachlan, J. H., & Cowie, B. C. (2015). The cascade of care for Australians living with chronic hepatitis B: measuring access to diagnosis, management and treatment. Australian and New Zealand Journal of Public Health, 39(3), 255-9. https://doi.org/10.1111/1753-6405.12345
Allard NL, MacLachlan JH, Cowie BC. The Cascade of Care for Australians Living With Chronic Hepatitis B: Measuring Access to Diagnosis, Management and Treatment. Aust N Z J Public Health. 2015;39(3):255-9. PubMed PMID: 25716519.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The cascade of care for Australians living with chronic hepatitis B: measuring access to diagnosis, management and treatment. AU - Allard,Nicole L, AU - MacLachlan,Jennifer H, AU - Cowie,Benjamin C, Y1 - 2015/02/25/ PY - 2014/06/01/received PY - 2014/08/01/revised PY - 2014/10/01/accepted PY - 2015/2/27/entrez PY - 2015/2/27/pubmed PY - 2016/8/10/medline KW - cascade of care KW - epidemiology KW - health systems KW - hepatitis B KW - liver cancer SP - 255 EP - 9 JF - Australian and New Zealand journal of public health JO - Aust N Z J Public Health VL - 39 IS - 3 N2 - OBJECTIVE: To estimate the level of access to diagnosis, management and treatment for people living with chronic hepatitis B (CHB) in Australia, and to identify the gaps in clinical care for people living with CHB. METHODS: Analysis of publicly available population level data including infectious disease notifications, Medicare and Pharmaceutical Benefits Scheme utilisation data, census-based estimates of CHB prevalence and burden, and mathematical modelling. RESULTS: In 2012, of the estimated 218,567 Australians living with CHB, 57% had been diagnosed, 17,367 people (8%) received recommended HBV DNA viral load testing (without treatment) and 10,987 (5%) received antiviral therapy. CONCLUSIONS: This analysis reveals substantial gaps in the cascade of care for CHB in Australia, most notably in diagnosis (with 43% undiagnosed) and in recommended yearly monitoring (87% not in care). The number receiving therapy represents only one-third of those estimated to require treatment to prevent progressive liver disease and liver cancer. IMPLICATIONS: These findings demonstrate that the majority of those affected are not receiving guideline-based care; highlight the need for improvements in opportunistic screening, engagement in care, and access to therapy; and provide a method to assess the impact of public health and clinical interventions in response to CHB over time. SN - 1753-6405 UR - https://www.unboundmedicine.com/medline/citation/25716519/The_cascade_of_care_for_Australians_living_with_chronic_hepatitis_B:_measuring_access_to_diagnosis_management_and_treatment_ L2 - https://doi.org/10.1111/1753-6405.12345 DB - PRIME DP - Unbound Medicine ER -