Needs Assessment on the Future of Hepatitis B Care

You are invited to participate in a needs assessment focused on the understanding and implementation of quantitative hepatitis B surface antigen (qHBsAg) testing. Your expertise and insights are essential to effectively address current clinical, logistical, and public health challenges associated with qHBsAg testing. The outcomes will be used to inform a series of regional workshops to ensure they directly address current needs and gaps in chronic hepatis B care, including the medical, logistical, and public health challenges associated with the introduction of qHBsAg testing. By participating, you will help shape the workshop curricula to directly address the needs and gaps in patient care and public health.

Please complete this survey to help address the needs and gaps in patient care and public health surrounding hepatitis B care. Your responses will remain confidential, and the survey will only take 5-10 minutes of your time.

Knowledge Assessment

1. Please indicate your level of familiarity with the following topics on HBV:

(1 = No current knowledge, 5 = I am an expert on this topic)

Questions	1	2	3	4	5
Symptoms of HBV infection	1	2	3	4	5
The impact of chronic HBV disease	1	2	3	4	5
How to screen for HBV	1	2	3	4	5
How to interpret diagnostic test results	1	2	3	4	5
How to diagnose HBV	1	2	3	4	5
How to manage chronic HBV infection	1	2	3	4	5

2. If left untreated, what are the potential long-term health consequences of chronic hepatitis B infection? Select all that apply.

No long-term effects exist

Hepatic decompensation

Hepatocellular carcinoma

End-stage liver disease

Liver cirrhosis

Increased mortality risk

I’m not sure

Awareness and Perceptions of qHBsAg Testing

1. Have you heard of quantitative Hepatitis B surface antigen (qHBsAg) testing before?

Yes

2. Do you order qHBsAg as part of your HBV management process?

Yes

3. If you currently order or interpret qHBsAg as part of your HBV process, for what clinical purposes do you use the results? Select all that apply.

Assessing stage of HBV chronicity

Assessing risk of disease progression

Assessing need for liver biopsy

Monitoring treatment response

Guiding treatment duration/discontinuation

I’m not sure

Not applicable

Other

Please Specify:

4. Please indicate your level of confidence with the following aspects of qHBsAg testing:

(1 = Not at all confident, 5 = Extremely confident)

Questions	1	2	3	4	5
Interpretation of qHBsAg results	1	2	3	4	5
Applying results to patient management	1	2	3	4	5

5. What do you believe are the primary barriers to the broader adoption and implementation of qHBsAg testing in your province/territory? Please select all that apply.

Lack of awareness among clinicians

Cost

Laboratory capacity

Consistency in testing procedures

Lack of clear guidelines

Integration into EMRs

Clinician comfort level

Perceived lack of clinical utility

Other

Please Specify:

6. What do you believe are the main barriers that prevent patients from being tested for qHBsAg? Please select all that apply.

Lack of awareness

Fear of stigma

Cost

Lack of access

Discomfort discussing with doctor

Patients don’t feel like they are at risk

Other

Please Specify:

Perceived Needs and Gaps

1. What type of information or resources would be most valuable to you to enhance your understanding and utilization of qHBsAg testing? Please select all that apply.

Clinical practice guidelines

Accredited educational programs

Educational workshops or webinars

Educational videos or animations

Clinical decision aids

Shared decision making tools

Standardized protocols for qHBsAg testing

Other

Please Specify:

2. What specific topics or challenges related to qHBsAg testing should be prioritized for discussion at a regional workshop aimed at healthcare professionals? Please rank from 1 to 10, where 1= most important and 10 = least important.

Please note: when ranking, you can use each number only once.

Questions	1	2	3	4	5	6	7	8	9	10
Integrating qHBsAg testing into clinical workflows	1	2	3	4	5	6	7	8	9	10
Defining disease progression and treatment response through the use of biomarkers	1	2	3	4	5	6	7	8	9	10
Accurately interpretating qHBsAg levels	1	2	3	4	5	6	7	8	9	10
Education on use of qHBsAg testing results to inform patient management	1	2	3	4	5	6	7	8	9	10
Ensuring resource availability	1	2	3	4	5	6	7	8	9	10
Assessing quality control	1	2	3	4	5	6	7	8	9	10
Enhancing HBV screening programs	1	2	3	4	5	6	7	8	9	10
Strategies for stakeholder engagement	1	2	3	4	5	6	7	8	9	10
Monitoring and evaluation systems	1	2	3	4	5	6	7	8	9	10
Addressing health disparities in HBV testing and care	1	2	3	4	5	6	7	8	9	10

References

Sachar Y, Congly SE, Burak KW, et al. Epidemiology, Treatment Patterns and Survival in Canadian Patients With Chronic Hepatitis B-Related Hepatocellular Carcinoma. J Viral Hepat. 2024;31(11):739-745. doi:10.1111/jvh.13989
Xiao Y, van Gemert C, Howell J, et al. A survey of knowledge, attitudes, barriers and support needs in providing hepatitis B care among GPs practising in Australia. BMC Prim Care. 2022;23(1):137. doi:10.1186/s12875-022-01754-3
Zhou K, Dodge JL, Grab J, Poltavskiy E, Terrault NA. Mortality in Adults with Chronic Hepatitis B Infection in the United States: A Population-Based Study. Aliment Pharmacol Ther. 2020;52(2):382-389. doi:10.1111/apt.15803
Liaw YF. Perspectives on Outcome Prediction in Patients With Chronic Hepatitis B Virus Infection. Gastro Hep Adv. 2023;3(2):162-166. doi:10.1016/j.gastha.2023.11.002
Kumar M, Pahuja S, Khare P, Kumar A. Current Challenges and Future Perspectives of Diagnosis of Hepatitis B Virus. Diagnostics. 2023;13(3):368. doi:10.3390/diagnostics1303036