Specialty care and education associated with greater disease-specific knowledge but not satisfaction with care for chronic hepatitis C

Aliment Pharmacol Ther. 2009 Aug;30(3):275-82. doi: 10.1111/j.1365-2036.2009.04036.x. Epub 2009 May 6.

Abstract

Background: Little is known about differences among hepatitis C virus (HCV) patients managed by generalists vs. specialists with respect to patient-centred outcomes, such as disease-specific knowledge, health-related quality of life (HRQoL) and satisfaction with care.

Aim: To examine selected patient-centred outcomes of HCV-related care provided in primary care, specialty care or both.

Methods: A total of 629 chronic HCV patients completed a survey including an HCV knowledge assessment and validated instruments for satisfaction and HRQoL. Multivariable linear regression was used to compare outcomes between groups.

Results: Adjusted total HCV knowledge score was lower among patients who did not attend specialty care (P < 0.01). Primary care and specialty patients did not differ in adjusted general HRQoL or satisfaction. Sixty percent of specialty patients underwent formal HCV education, which was associated with 5% higher knowledge score (P = 0.01). General HRQoL and patient satisfaction did not differ between primary care and specialty groups. Disease-specific knowledge and care satisfaction were independent of mental illness, substance abuse, socio-economic variables, history of antiviral treatment, formal HCV education and duration of time between last visit and survey completion.

Conclusions: Primary care patients with chronic HCV have lower adjusted disease-specific knowledge than specialty patients, but no difference in general HRQoL or patient satisfaction.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gastroenterology / standards*
  • Hepatitis C, Chronic / therapy*
  • Humans
  • Male
  • Medicine / standards
  • Middle Aged
  • Patient Education as Topic / standards*
  • Patient Satisfaction*
  • Primary Health Care / standards*
  • Quality of Health Care / standards*
  • Quality of Life / psychology
  • Surveys and Questionnaires
  • Young Adult