Development of a stratified care pathway for primary biliary cholangitis: patient and clinician perspectives on management in primary care

Corrigan, Margaret (2021). Development of a stratified care pathway for primary biliary cholangitis: patient and clinician perspectives on management in primary care. University of Birmingham. M.D.

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Abstract

With the introduction of new guidelines for the management of Primary Biliary Cholangitis based on a stratified approach to care, the purpose of this research was to establish current practice in the UK and to ascertain the stakeholder perspective around the management of patients with low-risk disease in primary care. Using a mixed-methods approach, this research combined the results of patient and clinician surveys, a scoping review, and semi-structured qualitative interviews with patients, representatives from the patient support groups, and clinicians from primary, secondary and tertiary care, in order to identify whether there were barriers to implantation of this pathway and, if so, what the factors were underlying these barriers. Results from this research identified that a stratified approach is not currently widespread in clinical practice in the UK and that a number of barriers to implementing this approach to care exist from both the patient and clinician perspective. In addition to the general barriers to discharge of patients with chronic disease to primary care (including financial, strategic and workload related issues), as a rare disease PBC carries a number of specific challenges to the involvement of primary care in its management.

Type of Work:

Thesis (Doctorates > M.D.)

Award Type:

Doctorates > M.D.

Supervisor(s):