Addiction Medicine Physicians and Care for Hepatitis C

DESCRIPTION (provided by applicant): Drug users are heavily and disproportionately affected by hepatitis C, yet they face numerous barriers to healthcare that place them at risk for substantially lower levels of hepatitis C care than non-drug users. Because of their continuous contact with individual drug users and their knowledge of and experience with the intricacies of their healthcare, physicians practicing addiction medicine are in a unique position to facilitate drug users' access to and success with hepatitis C treatment. However, no data exists to describe the knowledge, attitudes and experience of addiction medicine physicians regarding hepatitis C care for drug users. We propose to nationwide survey of over 800 physician members of the American Society of Addiction Medicine (ASAM). Non-ASAM physicians practicing medicine in methadone maintenance treatment programs New York State will also be surveyed and compared to ASAM members to determine the generalizability of findings derived from the latter cohort. The proposed study will address the following specific aims: Aim 1: To describe the knowledge of and attitudes towards eligibility guidelines for hepatitis C treatment among physicians in addiction medicine, and determine the association between these attitudes and the physicians' provision of hepatitis C treatment to DUs, either direct or by referral; Aim 2: To determine the association between provision of HIV care by physicians in addiction medicine and the provision of hepatitis C treatment to DUs, either direct or by referral; Aim 3: To determine the association between the availability of onsite primary medical care in drug treatment programs and provision of hepatitis C treatment to DUs, either direct or by referral, by physicians in addiction medicine. The survey will focus on physicians' knowledge and attitudes surrounding treatment eligibility criteria, such as duration of abstinence from drug and alcohol use and history of depression. It will query physicians about their experience with hepatitis C treatment for drug users, either by referral or by direct management themselves, and their access to treatment resources. It will also inquire about their clinical practice setting and their professional background. The proposed study will identify strengths and weaknesses in the delivery of hepatitis C healthcare by addiction medicine physicians to drug users, and it will focus on collecting data useful for the development of interventions designed to improve drug users' access to hepatitis C treatment. Data from this study will have relevance to both drug abuse treatment policy and clinical practice.