Limited impact of awareness‐raising campaigns on hepatitis C testing practices among general practitioners

Abstract

The global hepatitis strategy calls for increased effort to diagnose those infected, with a target of 90% diagnosed by 2030. Scotland's Action Plan on Hepatitis C included awareness-raising campaigns, undertaken during 2008-2011, to promote testing by general practitioners. We examined hepatitis C virus (HCV) testing practice among general practitioners before and following these campaigns. Scottish general practitioners were surveyed, using Dillman's method, in 2007 and 2013; response rates were 69% and 60%, respectively. Most respondents offer testing when presented with a risk history (86% in 2007, 88% in 2013) but only one-fifth actively sought out risk factors (19% in 2007, 21% in 2013). Testing was reportedly always/almost always/usually offered to people who inject drugs (84% in 2007, 87% in 2013). Significant improvements in the offer of testing were reported in patients with abnormal LFTs (41% in 2007, 65% in 2013, P<.001) and who had received medical/dental treatment in high prevalence countries (14% in 2007, 24% in 2013, P=.001). In 2013, 25% of respondents had undertaken HCV-related continued professional development. This group was significantly more likely to actively seek out risk factors (P=.009) but only significantly more likely to offer a test to patients who had received medical/dental treatment in high prevalence countries (P=.001). Our findings suggest that government-led awareness raising campaigns have limited impact on general practitioners' testing practices. If the majority of the HCV-infected population are to be diagnosed, practitioner-based or physician-centred interventions should be considered alongside educational initiatives targeted at professionals.

Awareness and knowledge of hepatitis C among health care providers and the public: A scoping review

“…Limited awareness of and knowledge about HCV have been identified as the key barriers to health care providers offering hepatitis C testing and for patients seeking testing (7). This lack of awareness and knowledge leads to continued HCV transmission and missed prevention and treatment opportunities.…”

Hepatitis C test uptake among historic blood transfusion recipients following media coverage of the Penrose Inquiry and an awareness‐raising campaign

“…There are several alternatives to awareness‐raising, which could be utilized. Practitioner‐based interventions have been shown to be effective in identifying former PWID in primary care . This could be expanded to identify individuals who may have had a blood transfusion in the past.…”

Les obstacles au dépistage du virus de l'hépatite C et les facteurs qui le facilitent : examen de la portée

“…Les contraintes de temps -plus spécifiquement, le temps de consultation limité, les priorités concurrentes et les longues procédures de soutien psychologique précédant et suivant le test de dépistage -étaient souvent citées comme des obstacles au dépistage du VHC (8,(10)(11)(12)(13). Il en résulte que les fournisseurs de soins de santé -particulièrement les médecins généralistesne posaient pas systématiquement à leurs patients de questions…”

“…On accorde souvent une basse priorité au VHC en raison de sa lente progression comparativement à d'autres problèmes de santé auxquels on doit s'attarder au cours de la consultation(8,11,15).Les longues procédures de soutien psychologique sont aussi apparues comme un obstacle aux fournisseurs de soins de santé qui offrent le dépistage du VHC. Au cours d'une étude réalisée dans un hôpital d'enseignement américain, 75 % des patients hospitalisés n'avaient pas subi de test de dépistage, car le médecin résident avait contourné le processus de dépistage(21).La plupart des fournisseurs de soins de santé comprennent l'importance d'aborder les facteurs de risque et de dépister le VHC; cependant, plusieurs ont reconnu éprouver des difficultés à soulever le sujet avec leurs patients(9).…”