Hepatitis C care delivery practices among buprenorphine prescribers and non-prescribers: results from a survey of Washington state primary care providers.

Background: Hepatitis C infection (HCV) and opioid use disorder (OUD) are syndemic in the U.S., thus primary care providers (PCPs) who treat OUD by prescribing buprenorphine can play key roles to advance HCV elimination targets. We compared HCV screening and treatment among PCPs who do and do not prescribe buprenorphine in Washington (WA) State.

Methods: This study utilized a cross-sectional survey of PCPs in WA State, designed to characterize HCV care delivery practices and experiences/attitudes toward HCV. In this study, the independent variable was self-reported buprenorphine prescribing, and the main outcomes were (1) guideline-concordant HCV screening and (2) directly providing treatment for HCV. We used descriptive statistics to describe respondent characteristics. We used logistic regression to assess the association between buprenorphine prescribing status and HCV screening and treatment outcomes.

Results: Our sample included 73 PCPs, of whom 55% prescribe buprenorphine. We found that 25% of buprenorphine prescribers directly treated HCV. There was over a 2x greater relative odds that buprenorphine prescribers would correctly screen for HCV relative to non-prescribers (OR = 2.24; 95% CI: 0.67-8.18, p = .20) and a nearly 2.5x greater relative odds that they would treat HCV relative to non-prescribers (OR = 2.42; 0.72-9.61; p = .17), although both findings were not statistically significant.

Conclusion: In a sample of PCPs in WA state, buprenorphine prescribers compared to non-prescribers appear more likely to screen for and directly treat HCV, yet only a minority treat HCV. Interventions are needed to enhance HCV guideline-concordant care among these and all PCPs on the frontlines of caring for persons with OUD.