University of Wisconsin–Madison Medical College of Wisconsin

Hepatitis C Treatment Knowledge and Practice Among Family Medicine Physicians in Wisconsin During the Current Hepatitis C Epidemic

Ruth Koepke, MPH; Wajiha Z. Akhtar, PhD, MPH; Vanessa M. Kung, MD, PhD; David W. Seal, PhD; Elizabeth Salisbury-Afshar, MD, MPH; Ryan P. Westergaard, MD, PhD, MPH

Published online May 26, 2021.

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ABSTRACT

Background: Curative treatment for hepatitis C virus (HCV) exists, making elimination of HCV possible. However, most people with HCV have not received treatment. One barrier is limited access to treatment providers. HCV treatment can be effectively provided by primary care providers and, since 2017, Wisconsin Medicaid allows nonspecialists to prescribe treatment. We surveyed family medicine physicians in Wisconsin to evaluate capacity for the provision of HCV treatment.

Methods: We mailed a survey to family medicine physicians in Wisconsin from June 25, 2018 through September 7, 2018. Physicians were asked whether they prescribe HCV treatment and about their knowledge regarding HCV treatment and relevant statewide Medicaid policy. Using multivariable logistic regression, we evaluated physician characteristics associated with prescribing HCV treatment.

Results: Of 1,333 physicians surveyed, 600 (45%) responded. Few respondents reported prescribing HCV treatment independently (1%; n = 4) or in consultation with a specialist (6%; n = 35). Only 6% (n = 36) reported having a “great deal” of knowledge about HCV treatment. Most (86%; n = 515) were not aware that family medicine physicians can now prescribe HCV treatment covered by Medicaid. Physicians who practiced in offices affiliated with health systems were less likely to prescribe HCV treatment than physicians who practiced in an independent office or a Rural Health Clinic.

Conclusions: Among family medicine physicians in Wisconsin, experience with and knowledge of HCV treatment was limited. Developing knowledge and skills among primary care providers is needed to expand treatment access and make progress toward HCV elimination. Studies are needed to evaluate treatment access in primary care offices affiliated with health systems.


Author Affiliations: Wisconsin Department of Health Services, Madison, Wisconsin (Koepke, Westergaard); University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Koepke, Akhtar, Kung, Salisbury-Afshar, Westergaard), Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana (Seal).
Corresponding Author: Ruth Koepke, MPH, Wisconsin Department of Health Services, 1 W Wilson St, Room 265, Madison, WI 53703; phone 608.267.0359; email ruth.koepke@dhs.wisconsin.gov.
Acknowledgements: We gratefully acknowledge the University of Wisconsin Survey Center for conducting the survey.
Funding/Support: Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number P30CA014520 and the National Institute on Drug Abuse of the National Institutes of Health under Award Number UG3DA044826. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Additional funding for survey distribution was provided by the Wisconsin Department of Health Services, Division of Care and Treatment Services.
Financial Disclosures: None declared.
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