A Qualitative Study of Perceived Barriers to Hepatitis C Care Delivery Among Health Providers in Washington State

With the arrival of direct-acting antivirals, the implementation of universal hepatitis C virus screening, and simplified treatment protocols, the landscape for managing hepatitis C has become less complicated and more adaptable to primary care settings. In 2019, Washington State created and implemented a statewide comprehensive plan aimed at eliminating hepatitis C by 2030. This study aims to understand provider-based perceptions about screening and treating hepatitis C, and how these perceptions influence care across Washington State. This is a qualitative study using semi-structured in-depth interviews exploring screening and treatment practices of health providers across Washington State. Qualitative data collection was guided by the Updated Consolidated Framework for Implementation Research. Data was analyzed using thematic analysis to identify key factors. Fourteen providers participated in interviews. Most providers (86%) treated hepatitis C, and (71%) of those providers also treated substance use disorders. Emerging themes included organizational barriers, patient barriers, provider barriers, and stigma. Healthcare provider shortages, high turnover in rural parts of the state, lack of provider knowledge about current guidelines and access to information, patient competing priorities, and lack of updated screening and treatment care models were identified as strong barriers to treatment implementation.