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A global view of hepatitis C: physician knowledge, opinions, and perceived barriers to care
Christopher E McGowan1, Ali Monis, Bruce R Bacon
1UNC Liver Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Insights
Barriers to hepatitis C virus (HCV) treatment are global, with physicians identifying patient factors like side effects and cost as key obstacles. Regional differences and physician knowledge impact these perceptions.
Area of Science:
- Hepatology
- Infectious Diseases
- Global Health
Background:
- Chronic hepatitis C virus (HCV) infection remains a significant global health burden.
- Despite advances in antiviral therapy, treatment rates remain low due to various barriers.
- Understanding provider perspectives on these barriers is crucial for improving patient access to care.
Purpose of the Study:
- To identify perceived barriers to hepatitis C virus (HCV) therapy among a global sample of treatment providers.
- To assess provider knowledge and opinions regarding HCV care and treatment challenges.
- To explore regional variations in perceived barriers to HCV treatment.
Main Methods:
- An international, multidisciplinary survey was conducted among 697 physicians from 29 countries.
- Physicians responded to 214 questions covering practice characteristics, opinions, knowledge, and perceived treatment barriers.
- Data were analyzed to identify significant barriers and their association with physician factors and region.
Main Results:
- Physicians worldwide identified patient-level barriers (e.g., fear of side effects, cost, treatment duration) as most significant.
- Significant regional variations were observed, with government and payer-level barriers prominent in certain areas.
- Physician knowledge and experience were strongly associated with perceived barriers, with notable differences across regions.
- Deficits in basic treatment principles and patient access to care were also reported globally.
Conclusions:
- Patient-level factors are perceived as the primary barriers to hepatitis C virus (HCV) treatment globally.
- Addressing awareness, education, and specialist availability is essential to overcome treatment impediments.
- Tailored strategies considering regional differences are necessary to improve HCV treatment delivery.
Unlabelled:
Chronic infection with the hepatitis C virus (HCV) is a leading cause of global morbidity and mortality. Although recent advances in antiviral therapy have led to significant improvements in treatment response rates, only a minority of infected patients are treated. Multiple barriers may impede the delivery of HCV therapy. The aim of this study was to identify perceived barriers to care, knowledge, and opinions among a global sample of HCV treatment providers. An international, multidisciplinary survey of HCV treatment providers was conducted. Each physician responded to a series of 214 questions concerning his or her practice characteristics, opinions regarding the state of HCV care, knowledge regarding HCV treatment, and perception of treatment barriers. A total of 697 physicians from 29 countries completed the survey. Overall, physicians viewed patient-level barriers as most significant, including fear of side effects and concerns regarding treatment duration and cost. There were distinct regional variations, with Central and Eastern European physicians citing government barriers as most important. In Latin America, the Middle East, and Africa, payer-level barriers, including lack of treatment coverage, were prominent. Overall, the perception of barriers was strongly associated with physician knowledge, experience, and region of origin, with the fewest barriers reported by Nordic physicians and the most reported by Middle Eastern and African physicians. Globally, physicians demonstrated deficits in basic treatment principles, including the role of viral kinetics and the management of treatment nonresponders. Two thirds of surveyed physicians believed that patients do not have adequate access to providers in their community.
Conclusion:
Barriers to HCV treatment vary globally, though patient-level factors are viewed as most significant by treating physicians. Efforts to improve awareness, education, and specialist availability are needed.
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