Testing and Linkage to Care Table 3: Common Barriers to HCV Treatment and Potential Strategies

Table 3. Common Barriers to HCV Treatment and Potential Strategies

 

Barrier Strategy
Contraindications to treatment (eg, comorbidities, substance abuse, and psychiatric disorders)
  • Counseling and education
  • Referral to services (eg, psychiatry and opioid substitution therapy)
  • Optimize treatment with simpler and less toxic regimens
Competing priority and loss to follow-up
  • Conduct counseling and education
  • Engage case managers and patient navigators (HIV model)
  • Co-localize services (eg, primary care, medical homes, and drug treatment)
Long treatment duration and adverse effects
  • Optimize treatment with simpler and better tolerated regimens
  • Education and monitoring
  • Directly observed therapy (tuberculosis model)
Lack of access to treatment (high cost, lack of insurance, geographic distance, and lack of availability of specialists)
  • Leverage expansion of coverage through the Patient Protection and Affordable Care Act
  • Participate in models of care involving close collaboration between primary care practitioners and specialists
  • Pharmaceutical patient assistance programs
  • Co-localize services (primary care, medical homes, drug treatment)
Lack of practitioner expertise
  • Collaboration with specialists (eg, via Project ECHO-like models and telemedicine)
  • Develop accessible and clear HCV treatment guidelines
  • Develop electronic health record performance measures and clinical decision support tools (eg, pop-up reminders and standing orders)
 

 

Reviewed June 2016.

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