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Knowledge, Attitudes, and Behaviors Related to Hepatitis C Screening and Treatment among Health Care Providers in Washington, DC

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Abstract

Elimination of chronic hepatitis C (HCV) will require scaling up treatment, including possible HCV treatment by primary care providers. The District of Columbia (DC) has a substantial population living with untreated hepatitis C, and treatment expansion would benefit the resident population. The aim of this study was to assess the knowledge, attitudes, and behaviors of primary care providers and specialists related to hepatitis C screening and treatment. We conducted a prospective, online survey of physicians and nurse practitioners (n = 153) in DC on their knowledge, attitudes, and behaviors related to hepatitis C screening and treatment, as well as referral patterns, interest in learning, and preferred learning modalities. We compared responses by provider type. Key findings indicated that HCV screening and treatment knowledge was higher among specialty physicians as compared to primary care providers. The most common reported facilitators of HCV screening included a prompt in the electronic medical record (63%), patient education (57%), and support staff (41%). While 71% reported that HCV treatment was important in the community they serve, only 26% indicated that access to HCV specialist expertise and consultation was a major area of need. Additionally, 59% reported that they refer all HCV patients to specialists for treatment. Primary care providers in DC had moderate interest in learning how to treat chronic hepatitis C, but they need additional training. Patients are typically referred to gastroenterology, infectious diseases, and hepatology specialists who may have limited capacity to expand treatment.

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Acknowledgements

We would like to thank the survey respondents for their participation. We would also like to thank the Health Licensing and Regulation Administration of DC Department of Health and the DC chapter of the American Academy of Family Physicians, for their support in recruitment of study participants.

Funding

This study originated from and was funded by the District of Columbia Department of Health, through a contract with George Washington University Milken Institute School of Public Health (Contract Number C75880).

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Authors and Affiliations

  1. District of Columbia Department of Health, HIV/AIDS, Hepatitis, STD and TB Administration, 899 N. Capitol Street NE, Washington, DC, 20002, USA

    Rupali Kotwal Doshi, Kate Drezner, Alexandra Lachmann, Paola Chanes-Mora, Leah Varga, Brittani Saafir-Callaway, Adam Visconti & Michael Kharfen

  2. George Washington University, 950 New Hampshire Avenue NW, Washington, DC, 20052, USA

    Rupali Kotwal Doshi, Max Ruben, Irene Kuo & Leah Varga

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  1. Rupali Kotwal Doshi
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Correspondence to Rupali Kotwal Doshi.

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Please see the Human Subjects Protections described in the Methods section for details. All procedures performed in this study were in accordance with the ethical standards of the institutional research committees of the DC Department of Health and George Washington University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Doshi, R.K., Ruben, M., Drezner, K. et al. Knowledge, Attitudes, and Behaviors Related to Hepatitis C Screening and Treatment among Health Care Providers in Washington, DC. J Community Health 45, 785–794 (2020). https://doi.org/10.1007/s10900-020-00794-z

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