Primary Care Boosts Hepatitis C Treatment Rates

What Did the Research Discover?

The research demonstrated that a 10-month quality improvement initiative significantly increased the number of Hepatitis C Virus (HCV) RNA-positive patients who initiated curative treatment in a primary care setting. The proportion of patients who started treatment rose from 66.0% to 75.5%, and of those who initiated treatment, an impressive 92.5% achieved Sustained Virologic Response (SVR), meaning they were cured of HCV.

The intervention was multifaceted and population-based, integrating several key strategies to improve care delivery. These included physician education sessions, a decision-support tool embedded in the electronic medical record (EMR), pharmacist involvement, mentorship from experienced clinicians, and proactive outreach to patients who had been diagnosed but had not yet received treatment.

Qualitative findings from physician focus groups and pharmacist interviews indicated that the intervention successfully raised awareness and boosted physician confidence in their ability to treat HCV within the primary care setting. The combination of peer mentorship, structured guidance through the EMR tool, and pharmacist collaboration made HCV treatment more approachable for primary care physicians who previously lacked experience in managing the disease.

However, the study also highlighted key challenges. Psychosocial factors, such as mental health conditions, substance use, and unstable housing, remained significant barriers to patient engagement and treatment adherence. Physicians expressed concerns that these issues complicated treatment efforts, even though direct-acting antivirals (DAAs) have a high cure rate and minimal side effects. Additionally, difficulty in reaching patients, outdated contact information, and low healthcare engagement were common obstacles that limited outreach effectiveness.

Despite these challenges, the study provides strong evidence that HCV treatment can be successfully integrated into primary care settings with the right support structures in place. The team-based approach, educational initiatives, and digital decision-support tools all played critical roles in achieving positive patient outcomes and increasing the number of individuals receiving curative therapy for HCV.

How Can I Apply This Information?

For healthcare providers, this study highlights the potential for primary care teams to take an active role in treating HCV rather than relying solely on specialists. By leveraging existing resources, such as pharmacists, digital decision-support tools, and peer mentorship programs, primary care physicians can effectively manage HCV treatment within their practice. This approach not only improves access to care but also helps reach underserved populations who may not engage with specialty healthcare settings. Clinics looking to expand HCV treatment should consider implementing structured protocols, training programs, and proactive patient outreach strategies to increase treatment rates.

For patients diagnosed with HCV, this research reinforces the importance of seeking treatment, as HCV is a curable disease with a simple and highly effective treatment regimen. Modern direct-acting antiviral (DAA) medications offer a 95% cure rate, typically requiring only 8 to 12 weeks of oral therapy with minimal side effects. If you have been diagnosed but have not yet pursued treatment, this study shows that primary care providers are increasingly equipped to manage HCV. Talk to your doctor about available treatment options and the potential for pharmacist-led medication support to help with adherence.

For public health organizations and policymakers, these findings provide compelling evidence that expanding HCV treatment within primary care settings can significantly improve treatment rates and patient outcomes. Integrating education, decision-support tools, and team-based care approaches can empower more healthcare providers to treat HCV confidently, reducing the burden on specialist clinics and improving overall access to curative therapy. Additionally, addressing psychosocial barriers—such as substance use disorders, mental health support, and housing instability—will be crucial in ensuring that more patients complete treatment and achieve SVR.

Ultimately, this study underscores the importance of making HCV treatment widely available and accessible in primary care. Whether you are a healthcare provider, patient, or policymaker, the key takeaway is that HCV is curable, and with the right support, more people can be successfully treated in community healthcare settings.

Source:

Stewart A, Craig-Neil A, Hodwitz K, Wang R, Cheng D, Arbess G, Jeon C, Juando-Prats C, Kiran T. Increasing treatment rates for hepatitis C in primary care. The Journal of the American Board of Family Medicine. 2023 Aug 9;36(4):591-602. https://pubmed.ncbi.nlm.nih.gov/37468214/