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Primary Care Physician Perspectives on Hepatitis C Management in the Era of Direct-Acting Antiviral Therapy

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Abstract

Background

Primary care physicians (PCPs) play a critical role in the care cascade for patients with chronic hepatitis C (CHC).

Aim

To assess PCP knowledge and perspectives on CHC screening, diagnosis, referral, and treatment.

Methods

An anonymous survey was distributed to PCPs who participated in routine outpatient care at our hospital.

Results

Eighty (36 %) eligible PCPs completed the survey. More than half were females (60 %) aged 36–50 (55 %) from family (44 %) or internal (49 %) medicine. Overall, PCPs correctly identified high-risk populations for screening, though 19 % failed to identify baby boomers and 45 % failed to identify hemodialysis patients as populations to screen. Approximately half reported they were able to screen at risk patients <50 % of the time secondary to time constraints and difficulty assessing if patients had already been screened. 71 % of PCPs reported they refer all newly diagnosed patients to specialty care. 70 % of PCPs did not feel up to date with current treatment. The majority grossly underestimated efficacy, tolerability and ease of administration, and overestimated treatment duration. Only 9 % felt comfortable treating CHC, even those without cirrhosis. Practice patterns were influenced by specialty and Veterans Affairs Hospital affiliation.

Conclusions

Although the majority of PCPs are up to date with CHC screening recommendations, few are able to routinely screen in practice. Most PCPs are not up to date with treatment and do not feel comfortable treating CHC. Interventions to overcome screening barriers and expand treatment into primary care settings are needed to maximize access to and use of curative therapies.

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Acknowledgments

This study was funded in part by the Tuktawa Foundation (Lok).

Author information

Authors and Affiliations

  1. Department of Internal Medicine, University of Michigan Health System, 2F208 UH, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA

    Mary Thomson

  2. Division of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, 3912 Taubman Center, 1500 East Medical Center Drive, SPC 5362, Ann Arbor, MI, 48109, USA

    Monica A. Konerman & Anna S. F. Lok

  3. Department of Family Medicine, University of Michigan Health System, 1801 Briarwood Circle Building 10, Ann Arbor, MI, 48109, USA

    Hetal Choxi

Authors
  1. Mary Thomson
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  2. Monica A. Konerman
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  3. Hetal Choxi
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  4. Anna S. F. Lok
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Corresponding author

Correspondence to Anna S. F. Lok.

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Conflict of interest

A.S.F.L. has received research grants from AbbVie, Bristol-Myers Squibb, Gilead, Idenix, and Merck; and has served as unpaid advisor for Gilead, and paid advisor for Merck. All the other authors have no relevant person interests to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standard of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Our institutional review board determined that our study did not require informed consent from the anonymous survey participants.

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Thomson, M., Konerman, M.A., Choxi, H. et al. Primary Care Physician Perspectives on Hepatitis C Management in the Era of Direct-Acting Antiviral Therapy. Dig Dis Sci 61, 3460–3468 (2016). https://doi.org/10.1007/s10620-016-4097-2

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  • DOI: https://doi.org/10.1007/s10620-016-4097-2

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