title: Improving the identification of priority populations to increase hepatitis B testing rates, 2012.
abstract: BACKGROUND
  It is estimated that over 40 % of the 218,000 people with chronic hepatitis B (CHB) in Australia in 2011 are undiagnosed. A disproportionate number of those with undiagnosed infection were born in the Asia-Pacific region. Undiagnosed CHB can lead to ongoing transmission and late diagnosis limits opportunities to prevent progression to hepatocellular carcinoma (HCC) and cirrhosis. Strategies are needed to increase testing for hepatitis B virus (HBV) (including culturally and linguistically diverse communities, Aboriginal and/or Torres Strait Islander (Indigenous) people and people who inject drugs). General practitioners (GPs) have a vital role in increasing HBV testing and the timely diagnosis CHB. This paper describes the impact of a GP-based screening intervention to improve CHB diagnosis among priority populations in Melbourne, Australia.
  
  
  METHODS
  A non-randomised, pre-post intervention study was conducted between 2012 and 2013 with three general practices in Melbourne, Australia. Using clinic electronic health records three priority populations known to be at increased CHB risk in Australia (1: Asian-born patients or patients of Asian ethnicity living in Australia; 2: Indigenous people; or 3): people with a history of injecting drugs were identified and their HBV status recorded. A random sample were then invited to attend their GP for HBV testing and/or vaccination. Baseline and follow-up electronic data collection identified patients that subsequently had a consultation and HBV screening test and/or vaccination.
  
  
  RESULTS
  From a total of 33,297 active patients, 2674 (8 %) were identified as a priority population at baseline; 2275 (85.1 %) of these patients had unknown HBV status from which 338 (14.0 %) were randomly sampled. One-fifth (n = 73, 21.6 %) of sampled patients subsequently had a GP consultation during the study period; only four people (5.5 %) were subsequently tested for HBV (CHB detected in n = 1) and none were vaccinated against HBV.
  
  
  CONCLUSIONS
  CHB infection is an important long-term health issue in Australia and strategies to increase appropriate and timely testing are required. The study was effective at identifying whether Asian-born patients and patients of Asian had been tested or vaccinated for HBV; however the intervention was not effective at increasing HBV testing.
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, Australia. carolinevg@burnet.edu.au.|Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia. carolinevg@burnet.edu.au.
authors.forename: Caroline
authors.initials: C
authors.lastname: van Gemert
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Wang
authors.affiliation: Cancer Council Victoria, Melbourne, Australia.
authors.forename: Jody
authors.initials: J
authors.lastname: Simmons
authors.affiliation: WHO Collaborating Centre for Viral Hepatitis, Doherty Institute, Melbourne, Australia.|Department of Medicine, University of Melbourne, Melbourne, Australia.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Cowie
authors.affiliation: GRHANITE™ Health Informatics Unit, Health and Biomedical Informatics Centre, University of Melbourne, Melbourne, Australia.
authors.forename: Douglas
authors.initials: D
authors.lastname: Boyle
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, Australia.|Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Stoove
authors.affiliation: Cancer Council Victoria, Melbourne, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Enright
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, Australia.|Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Hellard
mesh_terms: D001315:Australia / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000517:prevention & control; D003153:Community Health Services / Q000458:organization & administration*; D005260:Female; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008113:Liver Neoplasms / Q000517:prevention & control; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D011322:Primary Prevention / Q000458:organization & administration*; D014611:Vaccination; D055815:Young Adult
chemical_list: D017325:Hepatitis B Vaccines
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