Opioid agonist therapy clinics represent an important conduit for people who inject drugs to receive information, screening and treatment for hepatitis C. Within these clinics, however, physicians and addiction specialists self-reported low competence regarding current HCV treatments. Additionally, policies that restrict treatment for current and recent drug users present an ongoing barrier.
“From a public health perspective, when you treat patients who are actively using, this is the population you need to treat if you want to achieve the WHO goals of elimination by 2030,” Alain H. Litwin, MD, professor of medicine and psychiatry at Albert Einstein College of Medicine, told Healio.com/Hepatology. “By treating people who are actively using, you can reduce the community viral load. For new patients who are uninfected or those who have been treated successfully, they will be less likely to be infected or reinfected. If you don’t treat the active users, we will never achieve the goal of elimination.”
Litwin discussed the results of the C-SCOPE study, presented this year at the International Symposium on Hepatitis Care in Substance Users. The aim of the study was to evaluate the competency of HCV testing, management and treating among physicians practicing in clinics that offer opioid agonist therapy.
Overall, 203 physicians replied to the C-SCOPE survey from the U.S. (n = 82), Europe (n = 92) and Australia and Canada (n = 29). The physicians included psychiatrists (29%), primary care or internal medicine physicians (26%), addiction medicine specialists (21%), addiction psychiatrists (20%), or other specialist (4%).
Most of the physicians saw testing (82%) and treatment (84%) as important for PWIDs. However, many physicians reported below average competency regarding treating and managing HCV (40%), knowledge of new treatments (37%), advising patients about new treatments (28%), interpretation of HCV test results (14%) and regular screening methods (12%).
“The majority of the physicians treating these patients are either psychiatrists or physicians specializing in addiction medicine,” Martine Drolet, global medical director at Merck, told Healio.com/Hepatology. “They do recognize the importance of screening and treating them, but they need support, they need education when it comes to recognizing treatments for their patients, when it comes to their own knowledge, and when it comes to even treating these patients
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