Hepatitis C knowledge among primary care residents

Is our teaching adequate for the times?

Angelo G. Coppola, Pietor C. Karakousis, David C. Metz, Mae F. Go, M. Mhokashi, Colin Howden, Jean Pierre Raufman, Virender K. Sharma

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

BACKGROUND: Increasingly, primary care (PC) physicians will be the first to encounter patients with hepatitis C virus (HCV) infection. AIM: To determine opinions and practices of PC residents regarding HCV. METHODS: We administered a one-page questionnaire to 180 PC residents at five U.S. training programs. RESULTS: Respondents were distributed equally across postgraduate year, 83% were U.S. graduates, and 44% had seen >11 (HCV) patients in the past year. Residents tested for HCV in persons with: increased transaminases (83%), history of blood transfusion (46%), multiple tattoos (57%), +ANCA (16%), and alcohol abuse (31%). Sixteen percent of respondents tested all patients. Forty-one percent would vaccinate HCV patients for hepatitis A and 65% for hepatitis B while only 19% and 78% knew the respective vaccination schedules. Although no vaccine is available, 66% recommended vaccination for HCV. Only 37% and 29%, respectively, reported HCV genotype 1 as most common and most resistant to treatment. Fifty-three percent recommend liver biopsy before treating HCV. Only 52% reported α-interferon (IFN) with ribavirin as initial treatment for HCV while 28% recommend ribavirin or lamivudine alone or combinations of IFN and lamivudine or amantadine. As contraindications to treatment, 33% reported AIDS with PCP infection, 19% coronary artery disease, and 19% suicidal ideation. Sixty-nine percent felt that there was insufficient information on HCV. CONCLUSIONS: Many PC residents lack adequate knowledge of recommended guidelines for the management of HCV. Many test for HCV in inappropriate situations, are unclear regarding available vaccines and their administration, and are uncertain about current treatment. Education of PC residents on guidelines for detection and management of HCV must be improved.

Original languageEnglish (US)
Pages (from-to)1720-1725
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume99
Issue number9
DOIs
StatePublished - Sep 1 2004

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Hepatitis C
Hepacivirus
Primary Health Care
Teaching
Lamivudine
Ribavirin
Interferons
Vaccination
Vaccines
Guidelines
Education
Amantadine
Antineutrophil Cytoplasmic Antibodies
Suicidal Ideation
Hepatitis A
Primary Care Physicians
Virus Diseases
Therapeutics
Transaminases
Hepatitis B

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Hepatitis C knowledge among primary care residents : Is our teaching adequate for the times? / Coppola, Angelo G.; Karakousis, Pietor C.; Metz, David C.; Go, Mae F.; Mhokashi, M.; Howden, Colin; Raufman, Jean Pierre; Sharma, Virender K.

In: American Journal of Gastroenterology, Vol. 99, No. 9, 01.09.2004, p. 1720-1725.

Research output: Contribution to journalArticle

Coppola, AG, Karakousis, PC, Metz, DC, Go, MF, Mhokashi, M, Howden, C, Raufman, JP & Sharma, VK 2004, 'Hepatitis C knowledge among primary care residents: Is our teaching adequate for the times?', American Journal of Gastroenterology, vol. 99, no. 9, pp. 1720-1725. https://doi.org/10.1111/j.1572-0241.2004.10370.x
Coppola, Angelo G. ; Karakousis, Pietor C. ; Metz, David C. ; Go, Mae F. ; Mhokashi, M. ; Howden, Colin ; Raufman, Jean Pierre ; Sharma, Virender K. / Hepatitis C knowledge among primary care residents : Is our teaching adequate for the times?. In: American Journal of Gastroenterology. 2004 ; Vol. 99, No. 9. pp. 1720-1725.
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abstract = "BACKGROUND: Increasingly, primary care (PC) physicians will be the first to encounter patients with hepatitis C virus (HCV) infection. AIM: To determine opinions and practices of PC residents regarding HCV. METHODS: We administered a one-page questionnaire to 180 PC residents at five U.S. training programs. RESULTS: Respondents were distributed equally across postgraduate year, 83{\%} were U.S. graduates, and 44{\%} had seen >11 (HCV) patients in the past year. Residents tested for HCV in persons with: increased transaminases (83{\%}), history of blood transfusion (46{\%}), multiple tattoos (57{\%}), +ANCA (16{\%}), and alcohol abuse (31{\%}). Sixteen percent of respondents tested all patients. Forty-one percent would vaccinate HCV patients for hepatitis A and 65{\%} for hepatitis B while only 19{\%} and 78{\%} knew the respective vaccination schedules. Although no vaccine is available, 66{\%} recommended vaccination for HCV. Only 37{\%} and 29{\%}, respectively, reported HCV genotype 1 as most common and most resistant to treatment. Fifty-three percent recommend liver biopsy before treating HCV. Only 52{\%} reported α-interferon (IFN) with ribavirin as initial treatment for HCV while 28{\%} recommend ribavirin or lamivudine alone or combinations of IFN and lamivudine or amantadine. As contraindications to treatment, 33{\%} reported AIDS with PCP infection, 19{\%} coronary artery disease, and 19{\%} suicidal ideation. Sixty-nine percent felt that there was insufficient information on HCV. CONCLUSIONS: Many PC residents lack adequate knowledge of recommended guidelines for the management of HCV. Many test for HCV in inappropriate situations, are unclear regarding available vaccines and their administration, and are uncertain about current treatment. Education of PC residents on guidelines for detection and management of HCV must be improved.",
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AU - Go, Mae F.

AU - Mhokashi, M.

AU - Howden, Colin

AU - Raufman, Jean Pierre

AU - Sharma, Virender K.

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N2 - BACKGROUND: Increasingly, primary care (PC) physicians will be the first to encounter patients with hepatitis C virus (HCV) infection. AIM: To determine opinions and practices of PC residents regarding HCV. METHODS: We administered a one-page questionnaire to 180 PC residents at five U.S. training programs. RESULTS: Respondents were distributed equally across postgraduate year, 83% were U.S. graduates, and 44% had seen >11 (HCV) patients in the past year. Residents tested for HCV in persons with: increased transaminases (83%), history of blood transfusion (46%), multiple tattoos (57%), +ANCA (16%), and alcohol abuse (31%). Sixteen percent of respondents tested all patients. Forty-one percent would vaccinate HCV patients for hepatitis A and 65% for hepatitis B while only 19% and 78% knew the respective vaccination schedules. Although no vaccine is available, 66% recommended vaccination for HCV. Only 37% and 29%, respectively, reported HCV genotype 1 as most common and most resistant to treatment. Fifty-three percent recommend liver biopsy before treating HCV. Only 52% reported α-interferon (IFN) with ribavirin as initial treatment for HCV while 28% recommend ribavirin or lamivudine alone or combinations of IFN and lamivudine or amantadine. As contraindications to treatment, 33% reported AIDS with PCP infection, 19% coronary artery disease, and 19% suicidal ideation. Sixty-nine percent felt that there was insufficient information on HCV. CONCLUSIONS: Many PC residents lack adequate knowledge of recommended guidelines for the management of HCV. Many test for HCV in inappropriate situations, are unclear regarding available vaccines and their administration, and are uncertain about current treatment. Education of PC residents on guidelines for detection and management of HCV must be improved.

AB - BACKGROUND: Increasingly, primary care (PC) physicians will be the first to encounter patients with hepatitis C virus (HCV) infection. AIM: To determine opinions and practices of PC residents regarding HCV. METHODS: We administered a one-page questionnaire to 180 PC residents at five U.S. training programs. RESULTS: Respondents were distributed equally across postgraduate year, 83% were U.S. graduates, and 44% had seen >11 (HCV) patients in the past year. Residents tested for HCV in persons with: increased transaminases (83%), history of blood transfusion (46%), multiple tattoos (57%), +ANCA (16%), and alcohol abuse (31%). Sixteen percent of respondents tested all patients. Forty-one percent would vaccinate HCV patients for hepatitis A and 65% for hepatitis B while only 19% and 78% knew the respective vaccination schedules. Although no vaccine is available, 66% recommended vaccination for HCV. Only 37% and 29%, respectively, reported HCV genotype 1 as most common and most resistant to treatment. Fifty-three percent recommend liver biopsy before treating HCV. Only 52% reported α-interferon (IFN) with ribavirin as initial treatment for HCV while 28% recommend ribavirin or lamivudine alone or combinations of IFN and lamivudine or amantadine. As contraindications to treatment, 33% reported AIDS with PCP infection, 19% coronary artery disease, and 19% suicidal ideation. Sixty-nine percent felt that there was insufficient information on HCV. CONCLUSIONS: Many PC residents lack adequate knowledge of recommended guidelines for the management of HCV. Many test for HCV in inappropriate situations, are unclear regarding available vaccines and their administration, and are uncertain about current treatment. Education of PC residents on guidelines for detection and management of HCV must be improved.

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