Abstract
Recently, the high mortality rate resulting from the reactivation of hepatitis B virus (HBV) through the use of immunosuppressive therapy or chemotherapy for fulminant hepatitis patients has been recognized as one of the most critical medical issues.
On May 19, 2014, we started a collaborative drug therapy management (HBV-CDTM) project to establish a preventive procedure that can be used to avoid HBV reactivation. Before starting the project, the project protocol developed by the commission of chemotherapy was approved by the Director of Iwakuni Clinical Center. We decided to manage the HBV screening demonstrated in the hepatitis B treatment guidelines in collaboration with pharmacists, doctors and medical technologists. To fill in clinical records when conducting HBV-CDTM, we used the “eXChart” of the electronic clinical record system “HOPE/EGMAIN-GX” to simplify tasks, information sharing among medical staff members with different duties and collection of electronic clinical data.
From May 19, 2014 to January 31, 2015, we applied HBV-CDTM to 211 patients in total, and found three patients (1.4%) were hepatitis B surface antigen (HBsAg)-positive, and 75 patients (35.5%) were hepatitis B core antibody positive and/or hepatitis B surface antibody-positive despite being HBsAg-negative. We extracted 78 high-risk patients of HBV reactivation through HBV-CDTM. In addition, the operation rate of HBV screening examination after the introduction of HBV-CDTM rose to 98.6% from that of 3.2% before introduction.
Through the HBV-CDTM project, we concluded that the introduction of HBV-CDTM enabled reduction of doctors' loads and enhanced the preventive procedure against HBV reactivation.
