Reasons for Nonattendance across the Hepatitis C Disease Course

Area of Science:

• Hepatology
• Public Health
• Qualitative Research

Background:

• Nonattendance for hepatitis C (HCV) care presents a significant barrier to effective disease management and treatment.
• Understanding the multifaceted reasons for patient nonattendance across the disease continuum is crucial for improving care engagement.

Purpose of the Study:

• To explore and describe patient, provider, and institutional factors contributing to nonattendance for hepatitis C (HCV) care.
• To identify themes related to nonattendance throughout the HCV disease course from multiple perspectives.

Main Methods:

• A descriptive qualitative study design was employed.
• Data were collected through interviews with 84 patients and health and social care providers.
• Thematic analysis was used to analyze the interview data.

Main Results:

• Six interrelated themes of nonattendance were identified: self-protection, determining benefits, competing priorities, knowledge gaps, access to services, and restrictive policies.
• Nonattendance patterns varied by disease stage, provider type, and patient context, often beginning at diagnosis due to lack of recommended follow-up.
• Factors promoting attendance included organized, low-barrier service access, nonjudgmental delivery, and higher patient/provider knowledge of HCV.

Conclusions:

• Nonattendance for HCV care is complex and influenced by various factors that change throughout the disease course.
• Missed opportunities exist for providers to encourage attendance, particularly at diagnosis.
• Interventions should focus on integrated health and social services, improved knowledge dissemination, and standardized liver disease monitoring protocols.