Physician-level determinants of HCV screening during pregnancy in a U.S. sample

Arch Gynecol Obstet. 2023 Jul 16. doi: 10.1007/s00404-023-07146-x. Online ahead of print.

Abstract

Purpose: The purpose of this study was to assess the association between select determinants and HCV screening guideline adherence among physicians who provide prenatal care.

Research question: What factors may act as determinants of guideline adherence to HCV screening among physicians who provide prenatal care?

Methods: We surveyed a national sample of physicians who provided prenatal care in 2021. The survey included questions from the Clinician Guideline Determinant (CGD) questionnaire, demographic characteristics, and medical practice characteristics. We estimated odds ratios and 95% confidence intervals (CIs) using semi-Bayesian logistic regression for the association between determinants and guideline adherence.

Results: Participants included 224 physicians in the United States who reported providing prenatal care. Most physicians practiced in private practice (65%) and the majority were members of the American College of Obstetricians and Gynecologists (ACOG; 91%). Less than half (43%; 95% CI: 36%-49%) of physicians reported regular use of the HCV screening guideline. Physicians who reported general knowledge about HCV (OR = 9.0, 95% CI 3.1-30) or endorsed agreement with ease of implementation (OR = 8.0, 95% CI 2.7-25) had higher odds of adherence to the HCV screening guideline.

Conclusion: Our study suggests that less than half of practicing prenatal care physicians adhere to HCV screening guidelines for pregnant patients. Our results may be useful as a preliminary screening of select determinants of guideline use for further investigation.

Keywords: Guideline adherence; Hepatitis C; Prenatal; Screening.