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Prescribing direct‐acting antivirals to treat hepatitis C virus in a general practice setting in Australia: ‘so why not do it’?
Author(s) -
Heard Emma,
Massi Luciana,
Smirnov Andrew,
Selvey Linda A.
Publication year - 2020
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.14648
Subject(s) - medicine , medical prescription , hepatitis c , family medicine , nursing , immunology
Abstract 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.