Increasing uptake of Hepatitis C virus infection case-finding, testing and treatment in primary care: HepCATT (Hepatitis C Assessment Through to Treatment Trial) qualitative evaluation

Background: Hepatitis C virus infection is a key cause of liver disease but can be cured in over 95% of patients. Approximately 70,000 people with HCV infection in England may not have been diagnosed and many more not treated. National Institute for Health and Care Excellence (NICE) suggests that interventions to increase case finding in primary care are likely to be cost effective. However, evidence of effective interventions is lacking. The Hepatitis C Assessment to treatment trial (HepCATT) assessed whether a complex intervention in primary care could increase HCV case-finding, testing and treatment.

Aim: To investigate the feasibility and acceptability of the HepCATT intervention.

Design and setting: Qualitative interviews with fourteen primary care practice staff. Normalisation process theory, which outlines the social processes involved in intervention implementation, informed thematic data analysis.

Results: Participants appreciated the HepCATT intervention for increasing HCV knowledge and awareness. Although some initial technical difficulties were reported, participants saw the benefits of using the audit tool to systematically identify patients with HCV infection risk factors and found it straightforward to use. Participants valued the opportunity to discuss HCV testing with patients, especially those that may not have been previously been aware of HCV risk. Future implementation should consider fully integrating software systems and additional resources to screen patient lists and conduct tests.

Conclusion: When supported by a complex intervention, primary care can play a crucial role in identifying and caring for patients with HCV infection, to help stem the HCV epidemic and prevent HCV related illness.