Primary Care and Hepatology Provider–Perceived Barriers to and Facilitators of Hepatitis C Treatment Candidacy and Adherence View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-08

AUTHORS

Shari S. Rogal, Rory McCarthy, Andrea Reid, Keri L. Rodriguez, Linda Calgaro, Krupa Patel, Molly Daley, Naudia L. Jonassaint, Susan L. Zickmund

ABSTRACT

BACKGROUND: Provider perceptions regarding barriers to and facilitators of hepatitis C (HCV) treatment initiation and adherence have not been fully evaluated in the interferon-free treatment era. New treatments have provided opportunities for non-specialists to treat HCV, underscoring the importance of understanding primary care provider (PCP) and specialist perspectives. METHODS: Based on qualitative sampling principles, 12 PCPs and 12 hepatology providers (HPs) from the VA Pittsburgh Healthcare System completed audio-recorded semi-structured interviews. Qualitative analysts coded perceived barriers and facilitators from the interviews with 100% double coding. Codes were thematized and analyzed using Atlas.ti. RESULTS: Key barriers to treatment described by HPs and PCPs included patients' substance use disorders, mental health, transportation availability, history of non-adherence, and concern about side effects. PCPs also focused on medication cost as a system-based barrier. The main facilitators of treatment initiation and adherence described by both HPs and PCPs were provider education and encouragement. HPs focused almost exclusively on provider-based facilitators, while PCPs noted patient-based facilitators including past adherence, media exposure to information about HCV medications, a desire to clear the virus, and positive feedback regarding treatment response. CONCLUSIONS: Providers generally focused on perceived patient-level barriers to HCV treatment initiation and adherence, as well as provider-level facilitators; PCPs additionally noted patient preferences and system-level issues that guide decision making regarding treatment initiation. While HPs focused almost exclusively on provider-level facilitators, PCPs additionally focused on patient-level facilitators of treatment. These data provide novel insights and suggest focusing on patient, provider, and system-level strategies to further improve HCV treatment initiation and adherence. More... »

PAGES

1933-1943

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10620-017-4608-9

DOI

http://dx.doi.org/10.1007/s10620-017-4608-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1085430513

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28523579


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