General practitioner attitudes to prescribing hepatitis C antiviral therapy in a community setting

Stephen M. Lambert, Andrew N. Page, Johannes Wittmann, Jeremy S. Hayllar, Clint W. Ferndale, Tanya M. Bain, Graeme A. Macdonald

There is a growing debate about the prescription of hepatitis C virus (HCV) antiviral therapies within a community setting in Australia. This study aimed to identify interest and confidence among general practitioners (GPs) in prescribing HCV antiviral therapy in a community setting. Data from 580 GPs who responded to a cross-sectional population-based survey were analysed to measure: self-reported interest and confidence in initiating HCV antiviral therapy; and/or prescribing maintenance antiviral therapy; and self-perceived education needs about HCV antiviral therapy. Forty-two percent of respondents indicated they would be interested in prescribing HCV antiviral therapy. Most were not confident to initiate therapy (80%). Higher proportions indicated that they would be more confident in prescribing maintenance therapy (35%) rather than initiating (7%) therapy (z=10.5, P<0.001). Confidence in prescribing was related to a higher caseload of patients with HCV (P=0.001) and being a HIV community-based prescriber (P=0.002). Fifty-three percent of respondents expressed an interest in education about HCV antiviral therapy. The initial step to recruit potential primary care prescribers of HCV antiviral therapies should be to develop an integrated education program. Recruitment to this program might be most efficient from GPs with a high caseload of patients with HCV.