title: Primary Care Providers Knowledge, Attitude and Practices Related to Hepatitis C Screening and Treatment in the Oral Direct Acting Antiviral Agents Era.
abstract: BACKGROUND
  There are over 3 million Americans infected with hepatitis C virus (HCV). Despite recent advances in HCV treatment, a major barrier to care remains a limited number of treaters. HCV therapy provision by primary care providers (PCPs) could expand access by increasing the pool of HCV treating clinicians.
  
  
  OBJECTIVE
  To characterize current HCV care practices, willingness and self-efficacy of PCPs to become HCV treaters.
  Two hundred and seventy one PCPs were identified from community clinics affiliated with a large academic center and 4 large federally qualified health centers in Baltimore, MD. An internet-based survey was administered to assess provider demographics, clinical practice site and willingness to provide HCV care. Factors associated with willingness to provide HCV care were examined using odds ratios (OR).
  
  
  RESULTS
  Among 129 (48%) PCPs who responded, the majority (70%) had an MD/DO degree and were white (60%). Only a few PCPs, 12 (10%), had treated at least 1 patient for HCV in the prior year. Although only 22% agreed that HCV treatment should be provided by PCPs, 84% were interested in more HCV training. Willingness to provide treatment was strongly linked to having a high proportion of HCV-infected patients (>20% versus <20%; OR 3.9; 95% confidence interval [CI] 1.5-10) and availability of other services at the primary care site including HIV treatment (OR 6.5; 95% CI 2.5-16.5), substance abuse treatment (OR 3.3; 95% CI 1.3-8.4) and mental health services (OR 4.9; 95% CI 2.0-12.1).
  
  
  CONCLUSIONS
  These data suggest that efforts to expand HCV medical provider capacity will be most impactful if they initially focus HCV training on PCPs with a high prevalence of HCV among their patients and existing systems to support HCV care.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: O
authors.initials: O
authors.lastname: Falade-Nwulia
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: A
authors.initials: A
authors.lastname: McAdams-Mahmoud
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: R
authors.initials: R
authors.lastname: Irvin
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: A
authors.initials: A
authors.lastname: Niculescu
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: K R
authors.initials: KR
authors.lastname: Page
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: M
authors.initials: M
authors.lastname: Mix
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Thomas
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Sulkowski
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Mehta
keywords: Hepatitis C; Primary care; Treatment