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Monday, May 15, 2017

Limited Impact of Awareness-Raising Campaigns on Hepatitis C Testing Practices among General Practitioners

Limited Impact of Awareness-Raising Campaigns on Hepatitis C Testing Practices among General Practitioners
Authors A McLeod, B L Cullen, S J Hutchinson, K M Roy, J F Dillon, E A Stewart, D J Goldberg Accepted manuscript online: 14 May 2017
Full publication history DOI: 10.1111/jvh.12724

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This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/jvh.12724

Abstract
The global hepatitis strategy calls for increased effort to diagnose those infected, with a target of 90% diagnosed by 2030. Scotland's Action Plan on Hepatitis C included awareness-raising campaigns, undertaken during 2008-2011, to promote testing by General Practitioners. We examined HCV testing practice among general practitioners before and following these campaigns. Scottish general practitioners were surveyed, using Dillman's method, in 2007 and 2013; response rates were 69% and 60%, respectively. Most respondents offer testing when presented with a risk history (86% in 2007, 88% in 2013) but only one fifth actively sought out risk factors (19 in 2007, 21% in 2013). Testing was reportedly always/almost always/usually offered to people who inject drugs (84% in 2007, 87% in 2013). Significant improvements in the offer of testing were reported in patients with abnormal LFTs (41% in 2007, 65% in 2013, p<0.001) and who had received medical/dental treatment in high prevalence countries (14% in 2007, 24% in 2013, p=0.001). In 2013, 25% of respondents had undertaken HCV-related Continued Professional Development. This group were significantly more likely to actively seek out risk factors (p=0.009) but only significantly more likely to offer a test to patients who had received medical/dental treatment in high prevalence countries (p=0.001). Our findings suggest that government-led awareness-raising campaigns have limited impact on general practitioners’ testing practices. If the majority of the HCV infected population are to be diagnosed, practitioner-based or physician-centred interventions should be considered alongside educational initiatives targeted at professional.

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