Provider reported implementation barriers to hepatitis C elimination in Washington State

Area of Science:

• Hepatology
• Public Health
• Infectious Diseases

Background:

• Hepatitis C (HCV) treatment is available, yet only 12% of diagnosed individuals in Washington State received it in 2018.
• Washington State initiated an HCV elimination plan in 2019 to improve screening and treatment access.

Purpose of the Study:

• To identify provider and health system barriers to implementing HCV screening and treatment in Washington State.

Main Methods:

• A 2022 online survey assessed 547 healthcare providers in Washington State regarding their HCV screening and treatment practices.
• Eligible providers practiced in primary care, infectious disease, gastroenterology, or community health settings.
• Survey questions covered screening/treatment practices, barriers, knowledge, stigma, and co-management willingness.

Main Results:

• HCV screening adoption was high (96%), with few reported barriers.
• Only 28% of providers treated HCV, with 71% referring patients elsewhere.
• Barriers to treatment included knowledge deficits (64%) and lack of organizational support (24%).

Conclusions:

• Despite high screening, significant barriers impede HCV treatment implementation in Washington State.
• Lack of treating clinicians and clinician knowledge deficits are primary obstacles to HCV treatment.
• Expanding and educating the HCV-treating clinician workforce is crucial for achieving HCV elimination by 2030.