Hallett Jonathan, Price Tina, Gray Corie, Rosenberg Shoshana, Lobo Roanna, Crawford Gemma
Collaboration for Evidence, Research and Impact in Public Health, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, 6102, Australia.
Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, V8P 5C2, Canada.
BMC Prim Care. 2025 May 13;26(1):157. doi: 10.1186/s12875-025-02865-3.
Hepatitis C is a significant public health challenge in Australia, particularly in diagnosis, treatment access, and ongoing care among people who inject drugs. Despite the availability of highly effective direct-acting antivirals and government subsidisation, treatment uptake has declined among this population in recent years, beyond what would be expected from the initial treatment of easier-to-reach patients.
This rapid scoping review aimed to identify barriers and enablers affecting primary care providers in prescribing direct-acting antivirals for hepatitis C treatment.
Studies were included if they: were published after 2014, focused on DAA treatment, included primary care provider perspectives, contained primary data, identified barriers/enablers to treatment, and were conducted in high-income countries.
Two databases (Web of Science and Google Scholar) were searched for peer-reviewed articles. Primary care stakeholders were consulted through an online survey (n = 10) and telephone interviews (n = 7) to contextualise and validate findings.
Data were charted using a standardised form capturing author, year, location, aim, participants, study details, and main findings. Analysis used a deductive approach to identify key themes.
Twenty-three articles, mostly quantitative studies, were included in the review. The analysis identified four key domains influencing direct-acting antiviral prescription: provider characteristics, healthcare systems and service delivery, models of care, and societal and structural issues.
This review provides insights into contemporary challenges in hepatitis C care delivery models and highlights critical structural, sociocultural, and interpersonal factors affecting testing and treatment, particularly for people who inject drugs. These findings have implications for improving direct-acting antiviral prescription rates in primary care settings.
丙型肝炎是澳大利亚一项重大的公共卫生挑战，尤其是在注射吸毒者的诊断、治疗获取及持续护理方面。尽管有高效的直接抗病毒药物且政府提供补贴，但近年来该人群的治疗接受率有所下降，降幅超出了对更容易接触到的患者进行初始治疗时的预期。
本快速综述旨在确定影响初级保健提供者开具直接抗病毒药物用于丙型肝炎治疗的障碍和促进因素。
若研究符合以下条件则纳入：2014年后发表，聚焦直接抗病毒药物治疗，纳入初级保健提供者的观点，包含原始数据，确定治疗的障碍/促进因素，且在高收入国家开展。
检索了两个数据库（科学网和谷歌学术）以查找同行评审文章。通过在线调查（n = 10）和电话访谈（n = 7）咨询了初级保健利益相关者，以对研究结果进行背景分析和验证。
使用标准化表格记录数据，表格内容包括作者、年份、地点、目的、参与者、研究细节和主要发现。分析采用演绎法确定关键主题。
本综述纳入了23篇文章，大多为定量研究。分析确定了影响直接抗病毒药物处方的四个关键领域：提供者特征、医疗保健系统与服务提供、护理模式以及社会和结构问题。
本综述深入探讨了丙型肝炎护理模式中的当代挑战，并突出了影响检测和治疗的关键结构、社会文化及人际因素，尤其是对注射吸毒者而言。这些发现对提高初级保健环境中直接抗病毒药物的处方率具有启示意义。
