Methods: We conducted focus groups and interviews about alcohol use and HCV with both non-dependent drinkers (as determined by the AUDIT) with HCV (N=62) and healthcare providers (N=14) who care for HCV patients at a metropolitan teaching hospital. All focus groups and interviews were audio-taped, transcribed, and analyzed using NVIVO, a qualitative data management and analysis program.

Results: The majority of the HCV diagnosed respondents indicated a healthcare provider told them to stop drinking “completely.” A smaller number said they were told an occasional drink was “fine” or “cut back.” When asked if providers explained why it was important to change this behavior, most respondents replied because of the “effect on the liver” and on disease progression. Other respondents mentioned the need to stop drinking for: treatment efficacy; overall “well-being;” or a “chance to live-longer.” Only a few respondents indicated they were not told to curtail their drinking nor received an explanation about the effects of alcohol on their HCV. Healthcare provider advice about alcohol and HCV was generally concordant with what patients heard, with some strongly telling the patient “no alcohol,” and others saying an “occasional drink” is acceptable. However, reports varied by provider type on how often they discussed alcohol with HCV patients. Nurses and gastroenterologists raised the issue with most patients while internists focused on alcohol use only with problematic drinkers. Despite these variations, providers were fairly consistent in telling patients that alcohol makes HCV progress faster and causes more damage to the liver than it would for someone without HCV. Gastroenterologists consistently described this graphically as “throwing fuel on a fire.”

Conclusion: The messages relayed to HCV patients about alcohol use by healthcare providers are generally concordant with what patients report hearing. However, the mixed messages different types of providers are sending about appropriate drinking levels is troubling. In order to make the best health-related decisions about their disease, HCV patients need to receive consistent information about alcohol consumption from all healthcare providers they may encounter.