Hepatitis C management by addiction medicine physicians: results from a national survey.
Drug users are disproportionately affected by hepatitis C virus (HCV), yet they face barriers to health care that place them at risk for levels of HCV-related care that are lower than those of nondrug users. Substance abuse treatment physicians may treat more HCV-infected persons than other generalist physicians, yet little is known about how such physicians facilitate HCV-related care. We conducted a nationwide survey of American Society of Addiction Medicine physicians (n = 320) to determine substance abuse physicians' HCV-related management practices and to describe factors associated with these practices. We found that substance abuse treatment physicians promote several elements of HCV-related care, including screening for HCV antibodies, recommending vaccinations against hepatitis A and B, and referring patients to subspecialists for HCV treatment. Substance abuse physicians who also provide primary medical or HIV-related care were most likely to facilitate HCV-related care. A significant minority of physicians were either providing HCV antiviral treatment or willing to provide HCV antiviral treatment.
Litwin
Alain H
AH
Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA. alitwin@montefiore.org
Kunins
Hillary V
HV
Berg
Karina M
KM
Federman
Alex D
AD
Heavner
Karyn K
KK
Gourevitch
Marc N
MN
Arnsten
Julia H
JH
D000998:Antiviral Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003625:Data Collection; D003695:Delivery of Health Care; D015658:HIV Infections / Q000517:prevention & control; D022362:Hepatitis A Vaccines / Q000627:therapeutic use; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans; D008403:Mass Screening; D008511:Medicine; D008605:Mental Health Services; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation; D013038:Specialization; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000534:rehabilitation*; D014481:United States
D000998:Antiviral Agents; D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines; D018937:Hepatitis C Antibodies