Title : Understanding barriers to Hepatitis C (HCV) screening in primary care setting
Abstract:
Primary care practitioners play a crucial role in HCV testing, early detection, and patient management. However, studies have shown that knowledge gaps and barriers exist among primary care practitioners regarding HCV testing. Recent MA DPH data showed that only 13.7% of patients were tested at least once between 2016 and 2020. We conducted a survey to assess the baseline knowledge of primary care practitioners in large integrated health system regarding HCV testing to identify potential barriers to universal HCV testing. A survey link was sent to 176 providers, and we received 45 responses with a response rate of 26%. 56% of the providers were physicians and rest were nurse practitioners and physician assistants. Almost 50% providers said they were familiar with current US task force screening guidelines. 86% suggested that they routinely screen all patients with once in a lifetime screen as recommended by guidelines. Nearly 50% providers mentioned patient refusal, patients missing annual physicals and difficulty assessing if they had already been screened as reasons for not ordering the test. Time constraints and other competing priorities was a hindrance to testing for up to 37% of providers. Unclear guidelines, insurance refusal for coverage, difficulty ordering the test, and language barrier were infrequent reported reasons. Only 18% of the cohort was comfortable with Hep C treatment if test resulted positive while others referred their patients to a specialist. The above highlights significant barriers and potential areas of intervention to improve hepatitis C screening in the community.
