An external evaluation of the ASHM HBV s100 Community Prescriber Program (the Program), conducted by Zest Health Strategies in July 2018, has highlighted the program's key successes, recommendations to improvement, as well as, key structural barriers to greater general practitioner involvement in chronic hepatitis B health care. 

The program provides initial training, ongoing support and continuing professional development (CPD) activities for general practitioners prescribing Highly Specialised Drugs for the treatment of chronic hepatitis B in all states and territories across Australia. The evaluation, covering the period from July 2015 to December 2017, aimed to measure the impacts of the program, describe program successes and opportunities for change, and provide recommendations to guide future implementation.

Key findings from the evaluation found:

  • The HBV s100 Prescriber Courses were robust and fit-for-purpose
  • The Program was promoted effectively to stakeholders and participants
  • Participants received timely communication from ASHM
  • The Program had strong stakeholder engagement
  • The Program had a strong contribution to participating GPs’ self-reported knowledge, confidence and practice when it came to chronic HBV
  • The Program has contributed to expanded access to community-based monitoring and treatment for people with chronic HBV

However, despite the successes of the Program, about 8 in 10 people living with chronic hepatitis B on treatment still receive care in specialist settings, and there is substantial unmet population need. Over 80% (197,411) of people living with chronic hepatitis B are not in care and 90,400 (38%) are undiagnosed.

Key structural barriers to greater GP involvement in chronic hepatitis B care include:

  • Relatively small numbers of patients available for GP management, given no formalised specialist-to-GP referral and limited patient awareness of GP chronic hepatitis B management
  • Competing priorities and the complexity of chronic hepatitis B management with perceived inadequate remuneration

The key recommendations for improving the Program were:

  1. Strengthen course access, promotion and participation, for example by further engaging non-accredited GPs in areas of particular need
  2. Better support new prescribers and course attendees who do not undergo accreditation, including intensive clinical advice and support for new prescribers
  3. Strengthen course delivery and ongoing GP prescriber support through greater consumer involvement in course delivery and trialing a community of practice model for GPs
  4. Address structural barriers to GP management of patients with hepatitis B, including systematic specialist-to-GP referral and systems to facilitate GP-to-GP referral for HBV management only
  5. Advocate and convene on key issues in the hepatitis B response such as disproportionately low investment in hepatitis B care relative to unmet need, low levels of screening and testing and GP remuneration structures

The evaluation was funded by the Commonwealth Department of Health, who have also provided significant funding to expand the ASHM HBV s100 Community Prescriber Program since 2016. For more information about the evaluation, or to request a copy of the full evaluation, contact katelin.haynes@ashm.org.au or 0423 058 692.

 

Download a copy of the evaluation summary