Prescribing direct-acting antivirals to treat hepatitis C virus in a general practice setting in Australia: 'so why not do it'?

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Author(s)
Heard, Emma
Massi, Luciana
Smirnov, Andrew
Selvey, Linda A
Griffith University Author(s)
Year published
2020
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Background: The recent implementation of a scheme to provide universal access to direct-acting antiviral (DAA) medication to treat hepatitis C virus (HCV) places Australia in a unique position to reach global HCV elimination goals. To achieve this, increasing the uptake and success of DAA treatment in general practice settings is essential. Aims: To explore current enablers and residual barriers to HCV treatment in general practice settings in the post-interferon era from both general practitioner (GP) and patient perspectives. Methods: Semi-structured interviews with 11 GP and 27 patients were conducted to draw out both ...
View more >Background: The recent implementation of a scheme to provide universal access to direct-acting antiviral (DAA) medication to treat hepatitis C virus (HCV) places Australia in a unique position to reach global HCV elimination goals. To achieve this, increasing the uptake and success of DAA treatment in general practice settings is essential. Aims: To explore current enablers and residual barriers to HCV treatment in general practice settings in the post-interferon era from both general practitioner (GP) and patient perspectives. Methods: Semi-structured interviews with 11 GP and 27 patients were conducted to draw out both challenges and facilitators particularly relevant to DAA uptake and treatment journeys. Results: Key enablers for successful treatment identified by this study included peer-led GP support and skill development, utilisation of electronic reminder systems, trusting relationships with patients and engaging with patients' social and family networks. Barriers related to accessible testing facilities and knowledge and confidence with DAA treatment continue to limit GP-led treatment. Conclusions: Despite a universal access scheme, barriers to DAA prescription in general practice settings remain. These include access to fibrosis testing and GP confidence in DAA prescription. Strengthening peer-led GP skill development and utilisation of electronic reminder systems may help GP prioritise HCV treatment. Access to fibrosis testing and pathology services with no out-of-pocket costs to patients, particularly in outer-metropolitan areas, should be urgently addressed.
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View more >Background: The recent implementation of a scheme to provide universal access to direct-acting antiviral (DAA) medication to treat hepatitis C virus (HCV) places Australia in a unique position to reach global HCV elimination goals. To achieve this, increasing the uptake and success of DAA treatment in general practice settings is essential. Aims: To explore current enablers and residual barriers to HCV treatment in general practice settings in the post-interferon era from both general practitioner (GP) and patient perspectives. Methods: Semi-structured interviews with 11 GP and 27 patients were conducted to draw out both challenges and facilitators particularly relevant to DAA uptake and treatment journeys. Results: Key enablers for successful treatment identified by this study included peer-led GP support and skill development, utilisation of electronic reminder systems, trusting relationships with patients and engaging with patients' social and family networks. Barriers related to accessible testing facilities and knowledge and confidence with DAA treatment continue to limit GP-led treatment. Conclusions: Despite a universal access scheme, barriers to DAA prescription in general practice settings remain. These include access to fibrosis testing and GP confidence in DAA prescription. Strengthening peer-led GP skill development and utilisation of electronic reminder systems may help GP prioritise HCV treatment. Access to fibrosis testing and pathology services with no out-of-pocket costs to patients, particularly in outer-metropolitan areas, should be urgently addressed.
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Journal Title
Internal Medicine Journal
Volume
50
Issue
9
Copyright Statement
© 2020 Royal Australasian College of Physicians. This is the peer reviewed version of the following article: Prescribing direct-acting antivirals to treat hepatitis C virus in a general practice setting in Australia: 'so why not do it'?, Internal Medicine Journal, 2020, 50 (9), pp. 1053-1058, which has been published in final form at https://doi.org/10.1111/imj.14648. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Subject
Cardiovascular medicine and haematology
Clinical sciences
Health services and systems
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
hepatitis C virus