Wagner Glenn, Osilla Karen Chan, Garnett Jeffrey, Ghosh-Dastidar Bonnie, Bhatti Laveeza, Witt Mallory, Goetz Matthew Bidwell
1RAND Corporation, Santa Monica, CA, USA.
J Int Assoc Physicians AIDS Care (Chic). 2012 Jul-Aug;11(4):245-51. doi: 10.1177/1545109712444163. Epub 2012 May 7.
Despite low uptake of hepatitis C virus (HCV) treatment among HIV co-infected patients, few studies have examined the factors that contribute to provider decisions to recommend treatment. Surveys of 173 co-infected patients and their primary care providers, as well as patient chart data, were collected at 3 HIV clinics in Los Angeles; 73% of the patients had any history of being recommended HCV treatment. Multivariate predictors of being offered treatment included being Caucasian, greater HCV knowledge, receiving depression treatment if depressed, and one's provider having a lower weekly patient load and more years working at the study site. These findings suggest that provider decisions to recommend HCV treatment are influenced by patient factors including race and psychosocial treatment readiness, as well as characteristics of their own practice and treatment philosophy. With changes to HCV treatment soon to emerge, further evaluation of factors influencing treatment decisions is needed to improve HCV treatment uptake.
尽管在合并感染人类免疫缺陷病毒（HIV）的患者中丙型肝炎病毒（HCV）治疗的接受率较低，但很少有研究探讨促使医疗服务提供者决定推荐治疗的因素。在洛杉矶的3家HIV诊所收集了173名合并感染患者及其初级保健提供者的调查数据，以及患者病历数据；73%的患者有过被推荐进行HCV治疗的历史。被提供治疗的多变量预测因素包括为白人、对HCV了解更多、抑郁时接受抑郁治疗，以及其医疗服务提供者每周的患者负担较低且在研究地点工作的年限较长。这些发现表明，医疗服务提供者推荐HCV治疗的决定受到患者因素（包括种族和心理社会治疗准备情况）以及他们自身的执业特点和治疗理念的影响。随着HCV治疗即将出现变化，需要进一步评估影响治疗决定的因素，以提高HCV治疗的接受率。
