David Whiteley
Developing a primary care-initiated hepatitis C treatment pathway in Scotland: a qualitative study
Whiteley, David; Speakman, Elizabeth M; Elliott, Lawrie; Jarvis, Helen; Davidson, Katherine; Quinn, Michael; Flowers, Paul
Authors
Elizabeth M Speakman
Lawrie Elliott
Helen Jarvis
Katherine Davidson
Michael Quinn
Paul Flowers
Abstract
Background: The ease of contemporary hepatitis C virus (HCV) therapy has prompted a global drive towards simplified and decentralised treatment pathways. In some countries, primary care has become an integral component of community-based HCV treatment provision. In the UK, however, the role of primary care providers remains largely focused on testing and diagnosis alone.
Aim: To develop a primary care-initiated HCV treatment pathway for people who use drugs, and recommend theory-informed interventions to help embed that pathway into practice.
Design and setting: A qualitative study informed by behaviour change theory. Semi-structured interviews were undertaken with key stakeholders (n = 38) primarily from two large conurbations in Scotland.
Method: Analysis was three-stage. First, a broad pathway structure was outlined and then sequential pathway steps were specified; second, thematic data were aligned to pathway steps, and significant barriers and enablers were identified; and, third, the Theoretical Domains Framework and Behaviour Change Wheel were employed to systematically develop ideas to enhance pathway implementation, which stakeholders then appraised.
Results: The proposed pathway structure spans broad, overarching challenges to primary care-initiated HCV treatment. The theory-informed recommendations align with influences on different behaviours at key pathway steps, and focus on relationship building, routinisation, education, combating stigmas, publicising the pathway, and treatment protocol development.
Conclusion: This study provides the first practicable pathway for primary care-initiated HCV treatment in Scotland, and provides recommendations for wider implementation in the UK. It positions primary care providers as an integral part of community-based HCV treatment, providing workable solutions to ingrained barriers to care.
Citation
Whiteley, D., Speakman, E. M., Elliott, L., Jarvis, H., Davidson, K., Quinn, M., & Flowers, P. (2022). Developing a primary care-initiated hepatitis C treatment pathway in Scotland: a qualitative study. British Journal of General Practice, 72, e668-e676. https://doi.org/10.3399/bjgp.2022.0044
Journal Article Type | Article |
---|---|
Acceptance Date | Mar 10, 2022 |
Online Publication Date | May 23, 2022 |
Publication Date | 2022-09 |
Deposit Date | Jun 9, 2022 |
Publicly Available Date | Jun 9, 2022 |
Journal | British Journal of General Practice |
Print ISSN | 0960-1643 |
Electronic ISSN | 1478-5242 |
Publisher | Royal College of General Practitioners |
Peer Reviewed | Peer Reviewed |
Volume | 72 |
Pages | e668-e676 |
DOI | https://doi.org/10.3399/bjgp.2022.0044 |
Keywords | general practice, hepatitis C, primary health care, qualitative research,Scotland, therapeutics |
Public URL | http://researchrepository.napier.ac.uk/Output/2877371 |
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