Τίτλος:
Adherence to follow-up and treatment recommendations in Greek and immigrant patients with chronic hepatitis B in Greece
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background/Aim Immigrants have multiple barriers to access to health care systems. We evaluated the adherence to follow-up and treatment recommendations of chronic hepatitis B virus (HBV) Greek and immigrant patients. Methods In total, 1001 consecutive adult patients with chronic HBV infection who visited our clinics for the first time between 2002 and 2011 were included. All patients born outside Greece were considered immigrants. Diagnosis was considered to be complete if patients could be classified into HBeAg-positive chronic hepatitis B (CHB), inactive carriers, HBeAg-negative CHB, or decompensated cirrhosis. Results Of the patients, 56% were Greeks and 44% were immigrants. Greeks visited our clinics at a significantly older mean age (50 vs. 35 years, P<0.001) and more frequently with advanced liver disease (11.4 vs. 6.4%, P=0.007). During the first year, Greeks more frequently had several tests and eventually a complete diagnosis (68 vs. 55%, P<0.001). Greeks were more frequently in the phase of HBeAg-negative CHB and less frequently in the phase of inactive carrier or HBeAg-positive CHB, but age was the main determinant for these differences in multivariate analysis. Treatment was initiated more frequently by Greeks than immigrants with treatment indications (86 vs. 65%, P<0.001). Only 30-33% of treated and 4-10% of untreated patients remained under follow-up at year 5, without significant differences between Greeks and immigrants. Conclusion Adherence to follow-up recommendations is rather poor for all chronic HBV patients. Immigrants are lost more frequently during the first year, but only small proportions of treated and particularly untreated Greek or immigrant patients remain under long-term follow-up. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Συγγραφείς:
Voulgaris, T.
Vlachogiannakos, J.
Ioannidou, P.
Papageorgiou, M.-V.
Zampeli, E.
Karagiannakis, D.
Georgiou, A.
Papazoglou, A.
Karamanolis, G.
Papatheodoridis, G.V.
Περιοδικό:
European Journal of Gastroenterology and Hepatology
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
antivirus agent; hepatitis B(e) antigen; peginterferon alpha; antivirus agent; biological marker, adult; antiviral therapy; Article; chronic hepatitis B; controlled study; decompensated liver cirrhosis; disease carrier; female; follow up; Greece; human; immigrant; liver disease; major clinical study; male; middle aged; multivariate analysis; patient compliance; priority journal; treatment indication; ambulatory care; blood; chi square distribution; clinical practice; comparative study; epidemiology; ethnology; follow up; Greece; health care disparity; Hepatitis B, Chronic; Kaplan Meier method; migrant; migration; odds ratio; patient compliance; practice guideline; protocol compliance; retrospective study; risk factor; time factor; treatment outcome; trends, Adult; Ambulatory Care; Antiviral Agents; Biomarkers; Chi-Square Distribution; Emigrants and Immigrants; Emigration and Immigration; Female; Greece; Guideline Adherence; Healthcare Disparities; Hepatitis B e Antigens; Hepatitis B, Chronic; Humans; Kaplan-Meier Estimate; Lost to Follow-Up; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Patient Compliance; Practice Guidelines as Topic; Practice Patterns, Physicians'; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome
DOI:
10.1097/MEG.0000000000000788
