Cargando…

A Telephone and Mail Outreach Program Successfully Increases Uptake of Hepatocellular Carcinoma Surveillance

Hepatocellular carcinoma (HCC) is a leading cause of cancer‐related death worldwide. Society guidelines recommend surveillance with abdominal ultrasound with or without serum alpha‐fetoprotein every 6 months for adults at increased risk of developing HCC. However, adherence is often suboptimal. We a...

Descripción completa

Detalles Bibliográficos
Autores principales: Aby, Elizabeth S., Winters, Adam C., Lin, Jonathan, Bui, Aileen, Kawamoto, Jenna, Goetz, Matthew B., Bhattacharya, Debika, Pisegna, Joseph R., May, Folasade P., Patel, Arpan A., Benhammou, Jihane N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262281/
https://www.ncbi.nlm.nih.gov/pubmed/32490319
http://dx.doi.org/10.1002/hep4.1511
_version_ 1783540608804061184
author Aby, Elizabeth S.
Winters, Adam C.
Lin, Jonathan
Bui, Aileen
Kawamoto, Jenna
Goetz, Matthew B.
Bhattacharya, Debika
Pisegna, Joseph R.
May, Folasade P.
Patel, Arpan A.
Benhammou, Jihane N.
author_facet Aby, Elizabeth S.
Winters, Adam C.
Lin, Jonathan
Bui, Aileen
Kawamoto, Jenna
Goetz, Matthew B.
Bhattacharya, Debika
Pisegna, Joseph R.
May, Folasade P.
Patel, Arpan A.
Benhammou, Jihane N.
author_sort Aby, Elizabeth S.
collection PubMed
description Hepatocellular carcinoma (HCC) is a leading cause of cancer‐related death worldwide. Society guidelines recommend surveillance with abdominal ultrasound with or without serum alpha‐fetoprotein every 6 months for adults at increased risk of developing HCC. However, adherence is often suboptimal. We assessed the feasibility of a coordinated telephone outreach program for unscreened patients with cirrhosis within the Veteran’s Affairs (VA) health care system. Using a patient care dashboard of advanced chronic liver disease in the VA Greater Los Angeles Healthcare System, we identified veterans with a diagnosis of cirrhosis, a platelet count ≤ 150,000/uL, and no documented HCC surveillance in the previous 8 months. Eligible veterans received a telephone call from a patient navigator to describe the risks and benefits of HCC surveillance. Orders for an abdominal ultrasound and alpha‐fetoprotein were placed for veterans who agreed to surveillance. Veterans who were not reached by telephone received an informational letter by mail to encourage participation. Of the 129 veterans who met the eligibility criteria, most were male (96.9%). The most common etiology for cirrhosis was hepatitis C (64.3%), and most of the patients had compensated cirrhosis (68.2%). The patient navigators reached 32.5% of patients by phone. Patients in each group were similar across clinical and demographic characteristics. Patients who were called were more likely to undergo surveillance (adjusted odds ratio = 2.56, 95% confidence interval: 1.03‐6.33). Most of the patients (72.1%) completed abdominal imaging when reached by phone. Conclusion: Targeted outreach increased uptake of HCC surveillance among patients with cirrhosis in a large, integrated, VA health care system.
format Online
Article
Text
id pubmed-7262281
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-72622812020-06-01 A Telephone and Mail Outreach Program Successfully Increases Uptake of Hepatocellular Carcinoma Surveillance Aby, Elizabeth S. Winters, Adam C. Lin, Jonathan Bui, Aileen Kawamoto, Jenna Goetz, Matthew B. Bhattacharya, Debika Pisegna, Joseph R. May, Folasade P. Patel, Arpan A. Benhammou, Jihane N. Hepatol Commun Original Articles Hepatocellular carcinoma (HCC) is a leading cause of cancer‐related death worldwide. Society guidelines recommend surveillance with abdominal ultrasound with or without serum alpha‐fetoprotein every 6 months for adults at increased risk of developing HCC. However, adherence is often suboptimal. We assessed the feasibility of a coordinated telephone outreach program for unscreened patients with cirrhosis within the Veteran’s Affairs (VA) health care system. Using a patient care dashboard of advanced chronic liver disease in the VA Greater Los Angeles Healthcare System, we identified veterans with a diagnosis of cirrhosis, a platelet count ≤ 150,000/uL, and no documented HCC surveillance in the previous 8 months. Eligible veterans received a telephone call from a patient navigator to describe the risks and benefits of HCC surveillance. Orders for an abdominal ultrasound and alpha‐fetoprotein were placed for veterans who agreed to surveillance. Veterans who were not reached by telephone received an informational letter by mail to encourage participation. Of the 129 veterans who met the eligibility criteria, most were male (96.9%). The most common etiology for cirrhosis was hepatitis C (64.3%), and most of the patients had compensated cirrhosis (68.2%). The patient navigators reached 32.5% of patients by phone. Patients in each group were similar across clinical and demographic characteristics. Patients who were called were more likely to undergo surveillance (adjusted odds ratio = 2.56, 95% confidence interval: 1.03‐6.33). Most of the patients (72.1%) completed abdominal imaging when reached by phone. Conclusion: Targeted outreach increased uptake of HCC surveillance among patients with cirrhosis in a large, integrated, VA health care system. John Wiley and Sons Inc. 2020-04-24 /pmc/articles/PMC7262281/ /pubmed/32490319 http://dx.doi.org/10.1002/hep4.1511 Text en © 2020 The Authors. Hepatology Communications published by Wiley Periodicals, Inc., on behalf of the American Association for the Study of Liver Diseases. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Aby, Elizabeth S.
Winters, Adam C.
Lin, Jonathan
Bui, Aileen
Kawamoto, Jenna
Goetz, Matthew B.
Bhattacharya, Debika
Pisegna, Joseph R.
May, Folasade P.
Patel, Arpan A.
Benhammou, Jihane N.
A Telephone and Mail Outreach Program Successfully Increases Uptake of Hepatocellular Carcinoma Surveillance
title A Telephone and Mail Outreach Program Successfully Increases Uptake of Hepatocellular Carcinoma Surveillance
title_full A Telephone and Mail Outreach Program Successfully Increases Uptake of Hepatocellular Carcinoma Surveillance
title_fullStr A Telephone and Mail Outreach Program Successfully Increases Uptake of Hepatocellular Carcinoma Surveillance
title_full_unstemmed A Telephone and Mail Outreach Program Successfully Increases Uptake of Hepatocellular Carcinoma Surveillance
title_short A Telephone and Mail Outreach Program Successfully Increases Uptake of Hepatocellular Carcinoma Surveillance
title_sort telephone and mail outreach program successfully increases uptake of hepatocellular carcinoma surveillance
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262281/
https://www.ncbi.nlm.nih.gov/pubmed/32490319
http://dx.doi.org/10.1002/hep4.1511
work_keys_str_mv AT abyelizabeths atelephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT wintersadamc atelephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT linjonathan atelephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT buiaileen atelephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT kawamotojenna atelephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT goetzmatthewb atelephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT bhattacharyadebika atelephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT pisegnajosephr atelephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT mayfolasadep atelephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT patelarpana atelephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT benhammoujihanen atelephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT abyelizabeths telephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT wintersadamc telephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT linjonathan telephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT buiaileen telephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT kawamotojenna telephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT goetzmatthewb telephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT bhattacharyadebika telephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT pisegnajosephr telephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT mayfolasadep telephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT patelarpana telephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance
AT benhammoujihanen telephoneandmailoutreachprogramsuccessfullyincreasesuptakeofhepatocellularcarcinomasurveillance