TY - JOUR
T1 - A qualitative study of end-stage liver disease and liver transplant referral practices among primary care providers in nonurban America
AU - Madabhushi, Vashisht V.
AU - Wright, Matthew
AU - Orozco, Gabriel
AU - Murphy, Allison
AU - Garcia, Antonio R.
AU - Pope, Natalie
AU - Mei, Xiaonan
AU - Cocca, Alexandra
AU - Gedaly, Roberto
AU - Gupta, Meera
N1 - Publisher Copyright:
© 2024 National Rural Health Association.
PY - 2025/1/1
Y1 - 2025/1/1
N2 - Purpose: In rural America, the road to obtaining a liver transplant (LTX) often starts at the primary care provider's (PCP's) office. Patients with end-stage liver disease (ESLD) in rural communities experience lower rates of wait-listing and higher mortality. This study identifies issues related to the knowledge and perceptions of ESLD and LTX referral among PCPs in rural Kentucky (KY). Methods: The study protocol involved relying upon a semistructured outline to explore the knowledge, attitude, and perceptions of PCPs toward ESLD and LTX referral among PCPs in rural KY. Inductive thematic analysis was utilized to identify, analyze, and report themes. Findings: From the focus group interviews, three themes were identified: medical culture, gaps in knowledge, and bias against those with self-induced causes of ESLD. Each theme illuminated barriers to referral for transplant evaluation. Conclusions: Knowledge gaps, attitudes in medical culture, and biases surrounding ESLD and LTX referral exist in community medicine practice. This highlights the importance of education, resources, and facilitation of LTX referral processes for PCPs.
AB - Purpose: In rural America, the road to obtaining a liver transplant (LTX) often starts at the primary care provider's (PCP's) office. Patients with end-stage liver disease (ESLD) in rural communities experience lower rates of wait-listing and higher mortality. This study identifies issues related to the knowledge and perceptions of ESLD and LTX referral among PCPs in rural Kentucky (KY). Methods: The study protocol involved relying upon a semistructured outline to explore the knowledge, attitude, and perceptions of PCPs toward ESLD and LTX referral among PCPs in rural KY. Inductive thematic analysis was utilized to identify, analyze, and report themes. Findings: From the focus group interviews, three themes were identified: medical culture, gaps in knowledge, and bias against those with self-induced causes of ESLD. Each theme illuminated barriers to referral for transplant evaluation. Conclusions: Knowledge gaps, attitudes in medical culture, and biases surrounding ESLD and LTX referral exist in community medicine practice. This highlights the importance of education, resources, and facilitation of LTX referral processes for PCPs.
KW - disparities
KW - liver
KW - primary care
KW - rural
KW - transplant
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U2 - 10.1111/jrh.12871
DO - 10.1111/jrh.12871
M3 - Article
AN - SCOPUS:85201571331
SN - 0890-765X
VL - 41
JO - Journal of Rural Health
JF - Journal of Rural Health
IS - 1
M1 - e12871
ER -