Theme: Epidemiology and Public Health Research Year: 2021
Background: Uptake of treatment has been limited amongst patients diagnosed with hepatitis C in Australia, despite the availability of pangenotypic direct-acting antivirals with relatively few side effects compared to historical interferon and ribavirin therapies. Currently, patient perspectives influencing the barriers and facilitators to hepatitis C treatment are not fully understood, especially in a primary healthcare context. Methods: This qualitative study aims to explore and characterise the barriers and facilitators that influence adherence and successful completion of hepatitis C treatment amongst patients on methadone in Greater Western Sydney. We conducted 15 semi-structured face-to-face interviews with patients on methadone who have undertaken treatment for hepatitis C and data was subsequently analysed via thematic content analysis using a qualitative phenomenological approach. Results: We identified patient-associated and healthcare system-associated facilitators and barriers to commencing therapy. Patient-related facilitators included a duty to community, patient agency and the perceived impact on family and intimate relationships. Healthcare system-related facilitators included accessibility to services and the importance of a positive clinician-patient relationship. In contrast, patient-related barriers to successful treatment included stigma and negative stereotypes regarding hepatitis C, reduced support networks and the existence of mental health co-morbidities. Furthermore, healthcare system-related barriers included a fear of interferon therapy and potential treatment side-effects, negative past experiences in the healthcare system and limited health literacy. Conclusion: Strengthening mainstream public health campaigns in promoting disease awareness and reducing the perceived barriers to treatment are essential to improving uptake of hepatitis C therapy. Moreover, our study emphasises the importance of mental and psychological heath in fostering patient engagement. A future model of care for hepatitis C treatment, centred on the intersecting domains of disease and treatment awareness, patient support and patient engagement is suggested. Disclosure of Interest Statement: The authors declare no conflicts of interest and no specific grants or funding was received in the development of this study.
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