Health Beliefs and Co-morbidities Associated with Appointment-Keeping Behavior Among HCV and HIV/HCV Patients

Abstract

Appointment-keeping behavior is an important requisite for HCV linkage and treatment initiation. In this study we examine what impact hepatitis C (HCV) knowledge and attitudes has on appointment-keeping behavior among a cohort of HCV and HCV/HIV patients. Knowledge scores and attitude scales, obtained from a cross-sectional survey, were correlated with proportion of appointments kept 1 year prior to taking the survey. Independent risk factors for missing appointments were examined by multiple regression analysis. 292 HCV patients completed the survey, and 149 (51%) were co-infected with HIV. HCV patients kept 67.5 ± 17.4% of their total appointments and a similar proportion (67 ± 38.2) of Liver Clinic appointments, but they attended a higher proportion (73 ± 24.4) of Primary Care Clinic appointments. However, certain health beliefs, psychiatric illness, and HIV co-infection were independently associated with lower levels of appointment-keeping behavior. HCV knowledge was not associated with appointment-keeping behavior. Health beliefs, psychiatric illness, and HIV co-infection are associated with missing appointments, but no link between knowledge and appointment keeping behavior is apparent. In order to increase engagement into HCV care, HCV care coordination programs need to focus on addressing health beliefs and providing resources to those at highest risk for missing appointments.

HCV Screening and Treatment Uptake Among Patients in HIV Care During 2014–2015

“…Second, active illicit drug use, alcohol consumption, mental health comorbidities, and engagement in HCV care (referral to HCV providers and HCV appointment keeping behavior) have been key factors for exclusion of DAA treatment, both in clinical trials and health care payer formularies. 27,28,32 We did not capture these factors, nor did we capture referrals for HCV treatment to either subspecialty clinics (hepatology) or infectious disease clinics within or not a HIV primary care system; we believe that the inclusion of this data would greatly improve the multivariate models. Finally, HCV management has changed since the advent of DAA, and further studies need to be conducted with the newer therapies available and lift of many insurance barriers for accessing newer DAA therapies.…”

Hepatitis C Virus Elimination in the Human Immunodeficiency Virus–Coinfected Population

“…29 Additionally, HIV coinfection has been associated with missed appointments among HCV-infected persons; appointment-keeping behavior is an important requisite for HCV linkage and treatment initiation. 45 Furthermore, a high proportion of coinfected patients have risk factors for poor engagement, including substance use and psychiatric diseases.…”