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Unmet Needs Among People Reported With Hepatitis C, New York City

Bornschlegel, Katherine MPH; Crotty, Kelly J. MD, MPH; Sahl, Sara MPH; Balter, Sharon MD

Journal of Public Health Management & Practice: July/August 2011 - Volume 17 - Issue 4 - p E9–E17
doi: 10.1097/PHH.0b013e3182053f1b
Original Article

Objective: This project sought to describe unmet needs among patients reported with hepatitis C in New York City.

Design: From the New York City Health Department's hepatitis C surveillance database, we randomly selected patients whose positive hepatitis C test was in April or May 2005. In 2006, we interviewed patients by telephone and collected information from their clinicians or by medical record review.

Setting: New York City.

Participants: We interviewed 180 of the 387 eligible patients and collected information from clinicians for 145 of the 180 patients.

Main Outcome Measures: These included whether patients had understood their clinicians' explanation of their hepatitis C diagnosis, if they had been counseled about not drinking alcohol, information about support group attendance, vaccination against hepatitis A and B, health status, treatment, and other factors.

Results: Of the 180 patients, 7% stated that they had not understood their clinicians' explanation of their hepatitis C diagnosis, and 26% said that they had not been counseled about avoiding alcohol. Among the 90% of patients who had not attended a hepatitis support group, 31% were interested in attending. Among the 145 patients with information from clinicians, at least 28% were susceptible to hepatitis A and 18% to hepatitis B.

Conclusions: This hepatitis C surveillance project, with information from patients and clinicians, illustrates a valuable use of a chronic hepatitis C surveillance system. The patients described here had several unmet needs, including hepatitis A and B vaccination, basic information about the virus, support groups, and counseling about preventing further liver damage and preventing transmission to others. Relatively simple and affordable health department activities can address these needs, improving quality of life and decreasing the likelihood of liver disease progression.

Relatively simple and affordable health department activities can address these needs, improving quality of life and decreasing the likelihood of liver disease progression.

New York City Department of Health and Mental Hygiene, New York. Dr Crotty is currently with the Department of Veterans Affairs, New York Harbor Healthcare System.

Correspondence: Katherine Bornschlegel, MPH, New York City Department of Health and Mental Hygiene, 125 Worth St, CN22A, New York, NY 10013 (kbornsch@health.nyc.gov).

This work was supported in part by an Emerging Infections Program grant from the Centers for Disease Control and Prevention.

The authors thank the many New Yorkers who spoke to them about their experience with hepatitis C, their clinicians who provided information, and staff who assisted with data collection: Firas Ahmed, Erin Bassett-Novoa, Carrie Mahowald, Catherine Richards, David Labowitz, and Elizabeth Livingstone.

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.