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AN EXAMINATION OF REGIONAL VARIATION IN TREATMENT OF HEPATITIS C PATIENTS IN CANADA
A Myles1, P Wang1, M Krahn2, G Mugford1
1Memorial University of Newfoundland, St John’s, NL; 2University of Toronto, Toronto, ON
Background and Aims: Approximately 170-175 million people worldwide are infected with Hepatitis C Virus (HCV) and the current prevalence of HCV in Canada is approximately 0.8%. It is known that treatment outcome and hence strategies differ based on factors such as genotype and viral load, liver histology, body weight, co-infection with HIV and adherence. Canadian hepatologists have varied perspectives towards treating HCV patients (Wang, Yi et al. 2003). The purpose of the study was to examine if there is regional variation in treating HCV and if this may be explained by differences in clinical opinions/practice among HCV health care providers (infectious disease specialists, hepatologists, gastroenterologists). It is hypothesized that regional variation in treatment exists because of lack of access to care.
METHODS: A nationwide anonymous postal survey was conducted to determine if treatment varies by geographical location. HCV health care providers were identified through the Canadian Medical Directory. A cover letter outlining study objectives and a questionnaire were sent to all eligible HCV health care providers. The survey requested information regarding health care provider demographics, referral pathways, treatment eligibility, pattern of drug prescribing, barriers to providing high quality service, and the role of physicians in providing treatment.
RESULTS: To this point, the data shows that there is a discrepancy between the number of physicians providing treatment to HCV patients. This suggests that access is related to the province where the patient resides.
CONCLUSIONS: Regional variations in HCV treatment continues to be a problem in Canada. The results gathered in this study may provide information to better understand current practices in order to plan future services for people living with HCV.
Funded by NCRTP + AIRN