Allegheny Health Network Pittsburgh, PA, United States
Scarlett Austin, DO, Divya Venkat, MD, Elizabeth Cuevas, MD Allegheny Health Network, Pittsburgh, PA
Introduction: An estimated 2.4 million people have chronic Hepatitis C virus (HCV) in the US. Literature has demonstrated HCV treatment managed by primary care providers’ results in a response comparable to that of subspecialists after a 3-hour training. Providers must be comfortable with HCV guidelines, testing, and treatment options in order to offer treatment in primary care. We aimed to better understand the comfort of internal medicine providers at different levels with testing for, discussing, and treating HCV.
Methods: A survey was distributed to Internal Medicine Residents and their overseeing outpatient attending physicians to assess knowledge and comfort with HCV. Surveyors identified their position. Comfort level with HCV testing and discussion of HCV treatment options were assessed on Likert scales. Screening guidelines were tested in multiple-choice format. True or false statements were posed: (1) partners of those with HCV should use barrier protection during intercourse, but it’s not necessary to take additional precautions such as using separate toothbrushes or nail clippers; (2) guidelines state that patients must refrain from drug and alcohol use for 6 months prior to HCV treatment initiation.
Results: There were 74 participants: 14 attending physicians, 20 PGY1, 24 PGY2, and 16 PGY3 residents. Over 65% felt comfortable to very comfortable testing the appropriate persons for HCV. Fewer than 30% felt comfortable to very comfortable treating HCV. Percentages of those within the aforementioned group increased with seniority, from 15% in PGY1s, to 25% in PGY2 and PGY3 groups, to 64% of attending physicians. A similar trend was seen in identifying proper precautions for HCV patients’ partners with correct answers in 55% of PGY1s, 62% of PGY2s and PGY3s, and 78% of attending physicians. This shift was reiterated when surveyors correctly identified that patients are not required to refrain from substance use for 6 months prior to treatment, with correct answers from 40% of PGY1s, 54% of PGY2s, 69% of PGY3s, and 93% of attending physicians.
Discussion: Our data suggests that as residents progress through training they become more informed about HCV treatment, guidelines and education. Comfort with HCV treatment increased with post-graduate level, demonstrating that education around HCV improves with experience and training. However, hesitancy to treat and false notions regarding substance use remain present. The need for continual and ongoing education is emphasized in order to eradicate HCV.
Figure: Assessment of Comfort with HCV Testing, Treatment, and Education by Position
Disclosures: Scarlett Austin indicated no relevant financial relationships. Divya Venkat indicated no relevant financial relationships. Elizabeth Cuevas indicated no relevant financial relationships.
Scarlett Austin, DO, Divya Venkat, MD, Elizabeth Cuevas, MD. P1818 - Assessing Comfort with Hepatitis C Screening, Education, and Treatment in Internal Medicine Primary Care Clinics, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.