SnapShots: Article: Primary Care Physician Perspectives on Hepatitis C Management in the Era of Direct-Acting Antiviral Therapy—M. Thomson et al
Source: Dig Dis Sci. 2016 Mar 8. [Epub ahead of print]
Study Aims and Results: The aim of the study was to assess the knowledge of primary care physicians (PCPs) on screening, diagnosis, referral and treatment of hepatitis C. Physicians at an outpatient hospital filled out an anonymous survey. Eighty PCPs (36%) completed the surveys. Sixty percent were female age 36-50 (55%) from family (44%) or internal (49%) medicine.
Overall, PCPs correctly identified high-risk populations for screening. Nineteen percent failed to identify baby boomers and 45% failed to identify hemodialysis patients as populations to screen. About half reported they were able to screen at-risk patients less than 50% of the time due to time constraints and difficulty assessing if patients had already been screened.
Seventy-one percent of PCPs reported they referred all newly diagnosed patients to specialty care.
Seventy percent 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 chronic hepatitis C, even those without cirrhosis.
Conclusions:The PCPs in this study were fairly knowledgeable about screening but did not screen in practice due to time constraints. Their knowledge about treatment was not up-to-date and they did not feel comfortable treating chronic hepatitis C.
Editorial Comment: This is terrible news! Primary care providers are a large part of the solution to eliminating HCV. The demand for treatment is increasing because we have treatments that have high cure rates, short treatment durations and low side effects. Insurance restrictions are easing, and increased awareness will bring more people into care and treatment. Educating and training PCPs to test, manage and treat hepatitis C should be high on everyone’s agenda.