— Christine M. Kukka, Project Manager, HBV Advocate
As mentioned in the above article, many doctors fail to screen
patients for past or present hepatitis B infections before prescribing
immune-suppressing chemotherapy. However, a recent initiative using
computerized reminders, improved screening rates markedly.
In the study, published in the February issue of PLoS One,
doctors who were about to prescribe chemotherapy to 965 patients were
reminded electronically to screen patients for hepatitis B. Only 88
patients in the study group had been previously screened for hepatitis
B.
Prompted by the reminders, the doctors in the
study achieved an 85.5% (825 of 965 patients) screening rate in
compliance with medical recommendations.
Unfortunately, many doctors failed to take the
next step and prescribe antivirals to stop hepatitis B reactivation in
these patients. Only 45.5% of patients whose screening uncovered prior
or current hepatitis B infections were prescribed antivirals during
chemotherapy.
“The rates of antiviral prophylaxis were lower
for doctors treating lung, breast and colorectal cancers than for those
treating hematological (blood) malignancies,” the researchers
reported.
Only 1.6% of antiviral-treated patients
experienced reactivation of their hepatitis B, compared to 15.1% of
patients who were not treated with antivirals and suffered HBV
reactivation during their cancer treatment.
“By using this reminder system, the overall
screening rate for HBsAg was satisfactory, whereas the antiviral
prophylaxis was inadequate in patients with solid tumors due to the
varying compliance of the attending doctors,” researchers wrote.
“Further strategies to improve both screening and prophylaxis are
needed to minimize HBV-related events during … chemotherapy.”
Source: www.ncbi.nlm.nih.gov/pubmed/
25658926
http://www.hbvadvocate.org/news/HBJ12.3.htmLabels: computers and screening, screen before chemotherapy
