title: Provider and patient correlates of provider decisions to recommend HCV treatment to HIV co-infected patients.
abstract: Despite low uptake of hepatitis C virus (HCV) treatment among HIV co-infected patients, few studies have examined the factors that contribute to provider decisions to recommend treatment. Surveys of 173 co-infected patients and their primary care providers, as well as patient chart data, were collected at 3 HIV clinics in Los Angeles; 73% of the patients had any history of being recommended HCV treatment. Multivariate predictors of being offered treatment included being Caucasian, greater HCV knowledge, receiving depression treatment if depressed, and one's provider having a lower weekly patient load and more years working at the study site. These findings suggest that provider decisions to recommend HCV treatment are influenced by patient factors including race and psychosocial treatment readiness, as well as characteristics of their own practice and treatment philosophy. With changes to HCV treatment soon to emerge, further evaluation of factors influencing treatment decisions is needed to improve HCV treatment uptake.
authors.affiliation: 1RAND Corporation, Santa Monica, CA, USA.
authors.forename: Glenn
authors.initials: G
authors.lastname: Wagner
authors.forename: Karen Chan
authors.initials: KC
authors.lastname: Osilla
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Garnett
authors.forename: Bonnie
authors.initials: B
authors.lastname: Ghosh-Dastidar
authors.forename: Laveeza
authors.initials: L
authors.lastname: Bhatti
authors.forename: Mallory
authors.initials: M
authors.lastname: Witt
authors.forename: Matthew Bidwell
authors.initials: MB
authors.lastname: Goetz
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D003430:Cross-Sectional Studies; D003657:Decision Making; D003863:Depression / Q000150:complications / Q000188:drug therapy; D037001:Directive Counseling; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D007722:Health Knowledge, Attitudes, Practice; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D012737:Sex Factors; D016526:Workload