BACKGROUND: Patients with hepatitis C viral (HCV) may perceive barriers to accessing speciality care for HCV, and these barriers may be related to depressive symptoms. AIM: To evaluate the relationship between barriers to care, demographics, and depressive symptoms. METHODS: A cross-sectional analysis of 126 patients referred for HCV at two speciality HCV clinics. Barriers to care, depressive symptoms and sociodemographics were measured using standardized instruments. A retrospective chart review was conducted to collect clinical outcome data. RESULTS: Depressive symptoms were reported in 26%. Common barriers included lack of personal financial resources; lack of HCV knowledge in the community; lack of professionals competent in HCV care; stigmatization of HCV; and long distances to clinics offering care. After we controlled for sociodemographics, depression accounted for an additional 7-18% of variability in all barriers (all p values <0.01). Lower depression, marital and employment status were associated with subsequent receipt of HCV treatment in 38% (45/120) of patients; perceived barriers were not. CONCLUSIONS: Depression is independently associated with perceived barriers to care. Higher depressive scores, but not perceived barriers, were associated with nontreatment. Healthcare providers who diagnose HCV need to be cognizant of numerous perceived barriers to accessing HCV care, and the impact that depression may have on these perceptions and receipt of treatment.
BACKGROUND:Patients with hepatitis C viral (HCV) may perceive barriers to accessing speciality care for HCV, and these barriers may be related to depressive symptoms. AIM: To evaluate the relationship between barriers to care, demographics, and depressive symptoms. METHODS: A cross-sectional analysis of 126 patients referred for HCV at two speciality HCV clinics. Barriers to care, depressive symptoms and sociodemographics were measured using standardized instruments. A retrospective chart review was conducted to collect clinical outcome data. RESULTS:Depressive symptoms were reported in 26%. Common barriers included lack of personal financial resources; lack of HCV knowledge in the community; lack of professionals competent in HCV care; stigmatization of HCV; and long distances to clinics offering care. After we controlled for sociodemographics, depression accounted for an additional 7-18% of variability in all barriers (all p values <0.01). Lower depression, marital and employment status were associated with subsequent receipt of HCV treatment in 38% (45/120) of patients; perceived barriers were not. CONCLUSIONS:Depression is independently associated with perceived barriers to care. Higher depressive scores, but not perceived barriers, were associated with nontreatment. Healthcare providers who diagnose HCV need to be cognizant of numerous perceived barriers to accessing HCV care, and the impact that depression may have on these perceptions and receipt of treatment.
Authors: M J Alter; D Kruszon-Moran; O V Nainan; G M McQuillan; F Gao; L A Moyer; R A Kaslow; H S Margolis Journal: N Engl J Med Date: 1999-08-19 Impact factor: 91.245
Authors: Brian R Edlin; Thomas F Kresina; Daniel B Raymond; Michael R Carden; Marc N Gourevitch; Josiah D Rich; Laura W Cheever; Victoria A Cargill Journal: Clin Infect Dis Date: 2005-04-15 Impact factor: 9.079
Authors: Maryam Alavi; Jason Grebely; Gail V Matthews; Kathy Petoumenos; Barbara Yeung; Carolyn Day; Andrew R Lloyd; Ingrid Van Beek; John M Kaldor; Margaret Hellard; Gregory J Dore; Paul S Haber Journal: J Gastroenterol Hepatol Date: 2012-05 Impact factor: 4.029
Authors: Christopher Woodrell; Jeffrey Weiss; Andrea Branch; Donald Gardenier; Katherine Krauskopf; Natalie Kil; Harold Paredes; Kian Bichoupan; Keith Sigel Journal: J Addict Med Date: 2015 Sep-Oct Impact factor: 3.702
Authors: Des Crowley; Walter Cullen; Eamon Laird; John S Lambert; Tina Mc Hugh; Carol Murphy; Marie Claire Van Hout Journal: J Transl Int Med Date: 2017-06-30
Authors: Christopher E McGowan; Ali Monis; Bruce R Bacon; Josep Mallolas; Fernando L Goncales; Ioannis Goulis; Fred Poordad; Nezam Afdhal; Stefan Zeuzem; Teerha Piratvisuth; Patrick Marcellin; Michael W Fried Journal: Hepatology Date: 2013-04 Impact factor: 17.425