ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 290
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Barriers and enablers to optimising primary care-directed
hepatitis C treatment: A qualitative study using the
theoretical domains framework
Dr Jui-Hsia Hung1,2, Justin Presseau1,2, Jeremy Grimshaw1,2
1
School of Epidemiology and Public Health, University of Ottawa, 2Centre for Implementation
Research, Ottawa Hospital Research Institute
Background
Accessibility of hepatitis C virus (HCV) infection testing and treatment is key to global HCV elimination.
However, the acceptability and implication of primary care-directed HCV treatment in developed
countries remain uncertain. Understanding the perception of primary care providers (PCPs) on HCV
treatment delivered in primary practice is needed to assess the feasibility of primary care-directed
HCV treatment.
Objective
We aim to determine the barriers and facilitators to optimising primary care-directed HCV treatment
perceived by family physicians (FPs) practicing in Ontario, Canada.
Methods
We conducted semistructured interviews with FPs to explore perceived barriers or enablers to
optimising primary care-directed HCV treatment. The interviews and content analysis were guided by
the Theoretical Domains Framework (TDF), which incorporates 33 theories of behaviour change into
14 domains to systematically identify cognitive, affective, social and environmental influences on health
behaviours. Main themes and significant TDF domains were identified and triangulated to illustrate key
determinants of essential steps in the primary care-directed HCV treatment pathway.
Results
Twenty FPs were interviewed, including seven participants providing HCV treatment in their practices.
Emerging main themes included knowledge of the latest HCV treatment guidelines, availability of
primary care-oriented HCV treatment algorithm and decision-making tools, perception regarding
whether HCV treatment is within the scope of primary care practice, accessibility of timely HCV
specialist consultation and support, government funding for DAA therapy and reimbursement process,
competing demand and prioritised medical conditions in primary care and patients’ ongoing HCV risk
profiles and adherence. Significant TDF domains included social and professional roles and identity,
social influence, environmental context and resources and knowledge.
Conclusion
Our study illustrated multifactorial barriers and facilitators to optimising primary care-directed HCV
treatment perceived by primary care physicians in the effort to inform future interventions to scale-up
HCV treatment capacity in primary care practice.
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