1. Improvement of quality of care provided to outpatients with hepatic cirrhosis after an educational intervention.
- Author
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Amador A, Salord S, Xiol X, Garcia-Guix M, Cachero A, Rota R, Hernandez Aretxabaleta N, Baliellas C, and Castellote J
- Subjects
- Humans, Female, Male, Cross-Sectional Studies, Middle Aged, Aged, Liver Neoplasms therapy, Esophageal and Gastric Varices etiology, Esophageal and Gastric Varices therapy, Esophageal and Gastric Varices prevention & control, Carcinoma, Hepatocellular therapy, Gastrointestinal Hemorrhage etiology, Gastrointestinal Hemorrhage prevention & control, Spain, Vaccination, Severity of Illness Index, Ambulatory Care standards, Guideline Adherence, Patient Education as Topic standards, Liver Cirrhosis complications, Liver Cirrhosis therapy, Quality Indicators, Health Care, Quality Improvement
- Abstract
Objective: A set of indicators has been reported to measure the quality of care for cirrhotic patients, and previously published studies report variable adherence rates to these indicators. This study aimed to assess the quality of care provided to cirrhotic outpatients before and after an educational intervention by determining its impact on adherence to quality indicators., Methods: We conducted a quasi-experimental, cross-sectional study including 324 cirrhotic patients seen in 2017 and 2019 at a tertiary teaching hospital in Spain. Quality indicators were assessed in five domains: documentation of cirrhosis etiology, disease severity assessment, hepatocellular carcinoma (HCC) screening, variceal bleeding prophylaxis, and vaccination. After identifying areas for improvement, an educational intervention was implemented. A second evaluation was performed after the intervention to assess changes in adherence rates., Results: Before the intervention, adherence rates were excellent (>90%) for indicators related to variceal bleeding prophylaxis and documentation of cirrhosis etiology, acceptable (60-80%) for HCC screening and disease severity assessment, and poor (<50%) for vaccinations. After the educational intervention, there was a statistically significant improvement in adherence rates for eight indicators related to HCC screening (70-90%), disease severity assessment (90%), variceal bleeding prophylaxis (>90%), and vaccinations (60-90%)., Conclusion: Our study demonstrates a significant improvement in the quality of care provided to cirrhotic outpatients after an educational intervention. The findings highlight the importance of targeted educational interventions to enhance adherence to quality indicators in the management of cirrhosis., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2024
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