TY - JOUR
T1 - Development of an intervention system for linkage-to-care and follow-up for hepatitis B and C virus carriers
AU - Kikuchi, Minami
AU - Sawabe, Motoji
AU - Aoyagi, Haruyo
AU - Wakae, Kosho
AU - Watashi, Koichi
AU - Hattori, Satoru
AU - Kawabe, Naoto
AU - Yoshioka, Kentaro
AU - Tanaka, Junko
AU - Muramatsu, Masamichi
AU - Wakita, Takaji
AU - Aizaki, Hideki
N1 - Funding Information:
The Ministry of Health, Labour and Welfare of Japan provided funding to Hideki Aizaki (Grant Nos. 19HC1001, 20HC1001, and 21HC2001). The Ministry of Education, Culture, Sports, Science and Technology of Japan provided funding to Hideki Aizaki (Grant No. 21K07974). The Advanced Research & Development Programs for Medical Innovation (AMED, AMED-CREST) provided funding to Hideki Aizaki (Grant Nos. 21fk0210066j0002, 21fk0310112j0705, 21fk0210047h0003, and 21fk0210086j0301).
Publisher Copyright:
© 2021, Asian Pacific Association for the Study of the Liver.
PY - 2022/2
Y1 - 2022/2
N2 - Background: Poor connections in the cascade of viral hepatitis care have been discussed around the world. In 2011 in Japan, 500,000 to 1.25 million hepatitis B and C virus carriers needed to consult with hepatologists, so linkage-to-care (LTC) needs to be promoted. Therefore, in this study, to improve LTC and care-seeking behaviors, we attempted to establish a community-based intervention system and evaluate its effectiveness by analyzing behavior modifications. Methods: In a model city, Okazaki (population: 387,887 as of 2019), LTC was encouraged among HBV and HCV carriers by annually mailed brochures, and their care-seeking behaviors were followed up through questionnaires for 8 years (2012–2019). Their behavior modifications and demographic characteristics were analyzed anonymously in cooperation with community health workers, hepatologists, and researchers. Results: Through regional HBsAg and anti-HCV screening, 333 HBV and 208 HCV carriers were identified. Before the intervention, only 34.7% (25/72) of HBV- and 34.3% (24/70) of HCV-positive individuals had consulted with hepatologists. However, in 2019, after the intervention, these proportions increased to 79.8% (91/114) and 91.2% (52/57), respectively. Access to outpatient care and treatment uptake also continuously improved. However, individuals over 70 years of age were significantly less likely to engage in care-seeking behaviors (p < 0.05), and significantly fewer HCV-positive females received treatment (p = 0.03). Conclusions: A paper-based reiterative intervention encouraging LTC and follow-up successfully improved the care-seeking behaviors of hepatitis virus-positive individuals and enabled their behavior modifications to be monitored. Further trials are required to advance the system by age- and gender-specific interventions. Graphical Abstract: [Figure not available: see fulltext.].
AB - Background: Poor connections in the cascade of viral hepatitis care have been discussed around the world. In 2011 in Japan, 500,000 to 1.25 million hepatitis B and C virus carriers needed to consult with hepatologists, so linkage-to-care (LTC) needs to be promoted. Therefore, in this study, to improve LTC and care-seeking behaviors, we attempted to establish a community-based intervention system and evaluate its effectiveness by analyzing behavior modifications. Methods: In a model city, Okazaki (population: 387,887 as of 2019), LTC was encouraged among HBV and HCV carriers by annually mailed brochures, and their care-seeking behaviors were followed up through questionnaires for 8 years (2012–2019). Their behavior modifications and demographic characteristics were analyzed anonymously in cooperation with community health workers, hepatologists, and researchers. Results: Through regional HBsAg and anti-HCV screening, 333 HBV and 208 HCV carriers were identified. Before the intervention, only 34.7% (25/72) of HBV- and 34.3% (24/70) of HCV-positive individuals had consulted with hepatologists. However, in 2019, after the intervention, these proportions increased to 79.8% (91/114) and 91.2% (52/57), respectively. Access to outpatient care and treatment uptake also continuously improved. However, individuals over 70 years of age were significantly less likely to engage in care-seeking behaviors (p < 0.05), and significantly fewer HCV-positive females received treatment (p = 0.03). Conclusions: A paper-based reiterative intervention encouraging LTC and follow-up successfully improved the care-seeking behaviors of hepatitis virus-positive individuals and enabled their behavior modifications to be monitored. Further trials are required to advance the system by age- and gender-specific interventions. Graphical Abstract: [Figure not available: see fulltext.].
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U2 - 10.1007/s12072-021-10269-5
DO - 10.1007/s12072-021-10269-5
M3 - Article
C2 - 34855104
AN - SCOPUS:85120482291
VL - 16
SP - 68
EP - 80
JO - Hepatology International
JF - Hepatology International
SN - 1936-0533
IS - 1
ER -