Patient-Identified Barriers to Hepatitis C Treatment.

Introduction: Hepatitis C virus (HCV) remains a public health concern in the United States. We developed a quality improvement project to address persistent challenges to HCV treatment at one primary care clinic. Challenges addressed included barriers to accessing specialist care to receive antiviral treatment and lack of patient resources, education, and awareness. Recognizing the potential for primary care providers to bridge treatment gaps, our initiative at an urban family medicine residency clinic in a large Midwest city targeted a patient population diagnosed with HCV but who remained untreated. Methods: Searching the medical record, we identified 40 eligible patients who had not received treatment despite a positive HCV diagnosis. Enrolled participants were asked to report their awareness, perceived barriers, and willingness to receive treatment in a primary care setting via a phone-assisted survey. Results: A total of 16 patients completed the survey (response rate 40%). Eighty-two percent were aware of their diagnosis, and 68.8% had not completed treatment. Only seven (43.8%) understood what an HCV infection is, while eight (50.0%) were aware that untreated HCV can lead to liver damage and cancer. Six (37.5%) claimed not to understand what an HCV infection is, and five reported that a medical professional had never explained it to them. Most respondents (81.2%) expressed a desire to initiate a treatment regimen and preferred to receive treatment at their primary care clinic. Conclusion: In an urban primary care residency clinic, HCV treatment is both possible and desired by patients.