Related Experiment Video
Updated: Mar 25, 2026
A Competent Hepatocyte Model Examining Hepatitis B Virus Entry through Sodium Taurocholate Cotransporting Polypeptide as a Therapeutic Target
Published on: May 10, 2022
The Patient-Provider Relationship Is Associated with Hepatitis C Treatment Eligibility: A Prospective Mixed-Methods
Shari S Rogal1,2, Robert M Arnold3, Michael Chapko4
1Center for Health Equity Research and Promotion, Veteran's Administration, Pittsburgh Healthcare Service, Pittsburgh, Pennsylvania, United States of America.
Insights
Hepatitis C virus (HCV) treatment eligibility is low, with only 16.5% of patients qualifying. Patient-provider relationship factors, like trust and communication, significantly impact eligibility for HCV cure.
Area of Science:
- Hepatology
- Gastroenterology
- Public Health
Background:
- Hepatitis C virus (HCV) infection is a leading cause of cirrhosis and hepatocellular carcinoma.
- Effective HCV treatment offers a potential cure, but eligibility remains a barrier for many patients.
- Understanding factors influencing treatment eligibility is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate patient-provider interactions and their association with Hepatitis C virus (HCV) treatment eligibility.
- To identify determinants of eligibility for interferon-based HCV therapy.
- To explore patient-reported barriers to HCV treatment.
Main Methods:
- Prospective cohort study at the VA Pittsburgh Healthcare System.
- Semi-structured interviews and validated questionnaires assessing depression, substance use, and HCV knowledge.
- Multivariate logistic regression analysis to identify factors associated with treatment eligibility.
Main Results:
- Only 16.5% (56 out of 339) of patients were deemed eligible for HCV therapy.
- Older age, concerns about the gastroenterology (GI) provider, and depression symptoms were associated with lower eligibility.
- Patients reported feeling stigmatized and experiencing poor provider communication as significant barriers.
Conclusions:
- Patient perceptions of their relationship with GI providers significantly influence HCV treatment eligibility.
- Establishing trust and effective communication can potentially reduce barriers to HCV cure.
- Addressing patient-provider dynamics is essential for optimizing access to life-saving HCV treatments.
Abstract:
Hepatitis C virus (HCV) treatment has the potential to cure the leading cause of cirrhosis and hepatocellular carcinoma. However, only those deemed eligible for treatment have the possibility of this cure. Therefore, understanding the determinants of HCV treatment eligibility is critical. Given that effective communication with and trust in healthcare providers significantly influences treatment eligibility decisions in other diseases, we aimed to understand patient-provider interactions in the HCV treatment eligibility process. This prospective cohort study was conducted in the VA Pittsburgh Healthcare System. Patients were recruited after referral for gastroenterology consultation for HCV treatment with interferon and ribavirin. Consented patients completed semi-structured interviews and validated measures of depression, substance and alcohol use, and HCV knowledge. Two coders analyzed the semi-structured interviews. Factors associated with patient eligibility for interferon-based therapy were assessed using multivariate logistic regression. Of 339 subjects included in this analysis, only 56 (16.5%) were deemed eligible for HCV therapy by gastroenterology (GI) providers. In the multivariate logistic regression, patients who were older (OR = 0.96, 95%CI = 0.92-0.99, p = .049), reported concerns about the GI provider (OR = 0.40, 95%CI = 0.10-0.87, p = 0.02) and had depression symptoms (OR = 0.32, 95%CI = 0.17-0.63, p = 0.001) were less likely to be eligible. Patients described barriers that included feeling stigmatized and poor provider interpersonal or communication skills. In conclusion, we found that patients' perceptions of the relationship with their GI providers were associated with treatment eligibility. Establishing trust and effective communication channels between patients and providers may lower barriers to potential HCV cure.
Related Concept Videos
01:25Hepatitis
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment