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What barriers delay treatment in patients with hepatitis C?

Kimberly Crosby1, Simone Bigelow1, Viviane Sachs1

  • 1University of Oklahoma School of Community Medicine, Department of Family and Community Medicine, Tulsa.

The Journal of Family Practice
|September 30, 2022
PubMed

Insights

Multiple patient and provider factors impede hepatitis C virus (HCV) treatment initiation. Addressing barriers like comorbidities, psychosocial issues, and adherence concerns is crucial for effective HCV management.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Hepatitis C virus (HCV) infection requires timely treatment for optimal outcomes.
  • Numerous patient-specific and provider-perceived factors can delay the initiation of curative therapies.
  • Understanding these barriers is essential for improving treatment access and efficacy.

Purpose of the Study:

  • To identify and categorize patient-specific and provider-perceived factors that delay HCV treatment initiation.
  • To synthesize evidence on the impact of various patient characteristics and provider perspectives on treatment delays.

Main Methods:

  • Systematic review of prospective and retrospective cohort studies.
  • Analysis of patient demographics, comorbidities (e.g., HIV coinfection, psychiatric illness), psychosocial factors, and substance abuse history.
  • Evaluation of provider perceptions regarding patient suitability and adherence risks.

Main Results:

  • Patient-specific barriers include age, race, gender, socioeconomic status, insurance, and comorbidities.
  • Provider-perceived barriers encompass substance abuse history, older age, psychiatric conditions, medical comorbidities, and adherence concerns.
  • Variability in data reporting for substance use disorders presents a limitation.

Conclusions:

  • A complex interplay of patient and provider factors hinders timely HCV treatment.
  • Addressing socioeconomic, psychosocial, and comorbidity-related barriers is vital for enhancing treatment initiation rates.
  • Further research with standardized reporting is needed to overcome data variability issues.

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