How Do General Practitioners Improve Compliance of Disease Monitoring by Patients with Chronic Hepatitis B Infection in Primary Care? A Qualitative Study

Background: Compliance to disease monitoring by patients with chronic hepatitis B infection (HBV carriers) presented a major obstacle to their management in primary care. Objective: The study determined the measures that general practitioners adopt to improve the compliance of disease monitoring by patients with chronic hepatitis B infection in primary care. Method: Focus group qualitative study of 43 general practitioners in primary care in Singapore. Results: GPs stressed that devoting time and effort to educate the HBV carriers on the natural disease and the reasons for disease monitoring would enhance compliance in the follow up of these patients. The GPs suggested that a patient-recall system and aidesmemoirs for doctors would also improve the compliance rate. Conclusion: Improving the HBV carriers' understanding of the natural disease process of hepatitis B, clarifying the need and relevance of hepatocellular carcinoma surveillance via disease monitoring was key to improving compliance. A patient-recall system and various aides-memoirs were perceived by the GPs to be useful measures to improve their compliance to follow-ups in primary care.