Limited impact of awareness-raising campaigns on hepatitis C testing practices among general practitioners

The global hepatitis strategy calls for increased effort to diagnose those infected, with a target of 90% diagnosed by 2030. Scotland's Action Plan on Hepatitis C included awareness-raising campaigns, undertaken during 2008-2011, to promote testing by general practitioners. We examined hepatitis C virus (HCV) testing practice among general practitioners before and following these campaigns. Scottish general practitioners were surveyed, using Dillman's method, in 2007 and 2013; response rates were 69% and 60%, respectively. Most respondents offer testing when presented with a risk history (86% in 2007, 88% in 2013) but only one fifth actively sought out risk factors (19 in 2007, 21% in 2013). Testing was reportedly always/almost always/usually offered to people who inject drugs (84% in 2007, 87% in 2013). Significant improvements in the offer of testing were reported in patients with abnormal LFTs (41% in 2007, 65% in 2013, p<0.001) and who had received medical/dental treatment in high prevalence countries (14% in 2007, 24% in 2013, p=0.001). In 2013, 25% of respondents had undertaken HCV-related Continued Professional Development. This group were significantly more likely to actively seek out risk factors (p=0.009) but only significantly more likely to offer a test to patients who had received medical/dental treatment in high prevalence countries (p=0.001). Our findings suggest that government-led awareness-raising campaigns have limited impact on general practitioners’ testing practices. If the majority of the HCV infected population are to be diagnosed, practitioner-based or physician-centred interventions should be considered alongside educational initiatives targeted at professional.