Qualitative analysis of the barriers and facilitators influencing uptake of direct-acting antiviral therapy for hepatitis C in a primary healthcare environment
Kevin Jia
A B * , Harsha Venkateshan B and Michael Burke B C
A Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
B School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia.
C Kildare Road Medical Centre, Blacktown, NSW 2148, Australia.
Australian Journal of Primary Health 28(3) 247-254 https://doi.org/10.1071/PY21180
Submitted: 29 July 2021 Accepted: 1 December 2021 Published: 10 March 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University.
Abstract
Historical interferon and ribavirin therapies for hepatitis C virus have been replaced by modern treatments with improved efficacy and tolerability. Despite the availability of direct-acting antiviral therapy, evidence demonstrates poor uptake in Australia. Presently, the barriers and facilitators influencing uptake of direct-acting antiviral therapy are not fully understood, especially in a primary healthcare environment. Our study aimed to discover methods of improving uptake of treatment in the community. We conducted 15 semi-structured, face-to-face interviews in a metropolitan, primary healthcare clinic in Australia. Interviews were recorded, transcribed and subsequently analysed using thematic content analysis. We identified patient-related and healthcare system-related barriers and facilitators to commencing treatment. This included established themes from current literature, and novel themes unique to direct-acting antiviral therapy and primary care. Overall, our study reinforces the importance of public health campaigns to promote community awareness and emphasises the concomitant role of mental health in fostering treatment uptake. Informed by our findings, we suggest further research on an integrated model of care, focused on the domains of disease awareness, patient engagement and treatment adherence. Hence, a community-oriented approach, driven by primary healthcare, ultimately underpins a successful public strategy to improve outcomes for patients affected by hepatitis C.
Keywords: adherence, barrier, direct-acting antiviral, facilitator, hepatitis C, interferon, primary health, treatment.
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