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ISRN Nursing
Volume 2013 (2013), Article ID 579529, 10 pages
Research Article

Reasons for Nonattendance across the Hepatitis C Disease Course

1UBC/BCCDC, 655 West 12th Avenue, Vancouver, BC, Canada V5Z 4R4
2BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, Canada V5Z 4R4

Received 27 May 2013; Accepted 2 August 2013

Academic Editors: A. Kenny and H. Rhee

Copyright © 2013 Gail Butt et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This descriptive qualitative study examined the patient, provider, and institutional factors contributing to nonattendance for hepatitis C (HCV) care throughout the disease course. Eighty-four patients and health and social care providers were interviewed. Thematic analysis of the data yielded 6 interrelated nonattendance themes: self-protection, determining the benefits, competing priorities, knowledge gaps, access to services, and restrictive policies. Factors within the themes varied with the disease course, type of provider/service, and patient context. Nonattendance could span months to years and most frequently began at diagnosis where providers either advised that followup was not necessary or did not recommend any followup. The way services were organized (low barrier access) and delivered (nonjudgmental approach) and higher HCV knowledge levels of patients and providers encouraged attendance. This is the first study to explore the reasons for nonattendance for HCV care throughout the disease course and validate them from multiple perspectives. There are missed opportunities for providers to encourage attendance throughout the disease course beginning at diagnosis. Interventions required include development of integrated health and social service delivery models; mechanisms to improve knowledge dissemination of the disease, its management, and treatment; and implementation of standardized followup protocols for liver disease monitoring in primary care.