The following is a summary of “Provider reported implementation barriers to hepatitis C elimination in Washington State,” published in the July 2024 issue of Primary Care by Cox-North et al.
Despite the availability of curative treatments since 2014, only 12% of individuals diagnosed with Hepatitis C (HCV) in Washington State received treatment in 2018. In response to this concerning statistic, Washington State agencies initiated an elimination plan in 2019 aimed at enhancing access to HCV screening and treatment. This study seeks to evaluate the barriers providers and health systems face in effectively implementing HCV screening and treatment initiatives across the state.
Methods for this investigation involved a cross-sectional online survey administered in 2022 to a sample of 547 healthcare professionals, including physicians, nurse practitioners, physician assistants, and clinical pharmacists, all of whom provide care to adult patients in various settings such as primary care, infectious disease, gastroenterology, and community health. The survey assessed practices related to HCV screening and treatment, identified implementation barriers, evaluated provider knowledge, explored observed stigma, and gauged willingness to co-manage HCV alongside substance use disorders. Statistical analyses, including chi-squared and Fisher’s exact tests, were employed to compare the characteristics of providers who screened or treated HCV with those who did not.
Results indicated that HCV screening was widely adopted, with 96% of providers reporting routine screening practices and minimal barriers to implementation. However, only 28% of providers reported treating HCV directly; the majority (71%) opted to refer patients to other specialists for treatment. Key barriers to treatment identified by those who did not prescribe included a significant knowledge deficit (64%) and insufficient organizational support (24%). Among those who provided treatment, the primary barrier noted was a lack of available treating clinicians (18%). Additionally, reports of observed stigma in treatment settings were low, with fewer than 10% indicating such experiences. Remarkably, 95% of clinicians expressed a willingness to prescribe medications for substance use disorders to patients who use drugs, including alcohol.
In conclusion, while screening for HCV is widespread in Washington State, substantial barriers persist in the treatment landscape. The most frequently cited challenges include a lack of knowledgeable treating clinicians and inadequate support for treatment efforts. To meet the goal of eliminating HCV by 2030, it is imperative to enhance both the workforce and the educational resources available to clinicians involved in HCV care.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02507-0