Screening High Risk Individuals for Hepatitis B: Physician Knowledge, Attitudes, and Beliefs.

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Dig Dis Sci. 2011 Oct 15. [Epub ahead of print]

Screening High Risk Individuals for Hepatitis B: Physician Knowledge, Attitudes,

and Beliefs.

T, Hon H, Kanwal F, Han S, Spiegel B.

Source

Division of Digestive Diseases, Emory University School of Medicine, 49

Hill Jr. Dr. S.E. Rm 437, Atlanta, GA, 30303, USA, tyfoste@....

Abstract

BACKGROUND:

Although the overall incidence of hepatitis B virus (HBV) has declined since the

introduction of universal vaccine guidelines, the incidence remains elevated in

high risk groups. Recent guidelines from the Centers for Disease Control (CDC)

have underscored the importance of vaccination against HBV in high risk

individuals. However, the incidence of HBV in this group remains elevated,

suggesting underuse of vaccinations by healthcare providers.

AIM:

The purpose of this study was to measure practice patterns of HBV vaccination,

and identify predictors of vaccination underuse.

METHODS:

We created a survey with four vignettes describing patients at high risk for

contracting HBV, followed by questions regarding knowledge, attitudes, and

beliefs (KAB) of HBV screening and vaccination. A random sample of 1,000

physicians, including internists, family medicine, OB/GYN, gastroenterologists,

and experts in HBV epidemiology were surveyed. Regression analysis on composite

guideline adherence scores identified KAB profiles that predict scores.

RESULTS:

On average, responders endorsed 71% of the CDC HBV vaccination guidelines. There

were three predictors of diminished screening proclivity: (1) younger provider

age (P = 0.028), (2) lower awareness that adult HBV is contracted primarily

through heterosexual sex (P = 0.023), and (3) being a provider other than a

gastroenterologist (P = 0.009).

CONCLUSIONS:

Respondents endorsed most-but not all-CDC supported HBV screening practices.

Lower adherence was predicted by specific and modifiable KAB profiles, and by

younger age. Future efforts to improve adherence should target trainees,

emphasize the importance of obtaining sexual histories in high risk patients,

and inform that HBV is predominantly a heterosexually transmitted infection.

PMID: 22001940 [PubMed - as supplied by publisher]