title: Outcomes of the implementation of the computer-assisted HBView system for the prevention of hepatitis B virus reactivation in chemotherapy patients: a retrospective analysis.
abstract: BACKGROUND
  Screening for hepatitis B virus (HBV) infection is recommended worldwide for patients receiving systemic chemotherapy in accordance with clinical guidelines, but compliance varies by country and facility. Alert systems may be useful for promoting screening, but it is unclear how effective such systems are. In this study, we investigated HBV screening procedures and their incorporation into treatment regimens following the implementation of an alert system.
  
  
  METHODS
  An alert system was introduced at our hospital in April 2012. The rates of HBV screening in the periods before and after the introduction of the alert system (September 2010 to March 2012 and April 2012 to October 2013, respectively) were investigated. We collected data on hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), hepatitis B core antibody (HBcAb), and HBV-DNA testing in patients. As a result of this analysis, we developed a system in which pharmacists would intervene to check and confirm whether HBV screening had occurred in patients scheduled to begin treatment with chemotherapy. We named our project the "HBView" project, and the rate of HBV screening and the number of times pharmacists intervened was studied during specific time periods before and after the HBView project commenced (July 2013 to December 2013 and January 2014 to June 2014, respectively).
  
  
  RESULTS
  After introducing the alert system, the percentage of patients tested for HBsAb/HBcAb and HBV-DNA increased significantly, from 71.6 % to 84.9 % and from 44.5 % to 69.7 %, respectively. However, the rate of compliance with HBV testing guidelines was not 100 % after interventions. The numbers of patients who were not screened but should have been before and after the introduction of HBView were 6 and 17, respectively. Two patients at risk of HBV reactivation were identified after intervention by pharmacists; their intervention thus prevented HBV reactivation.
  
  
  CONCLUSIONS
  Compliance with clinical HBV screening guidelines was not sufficiently improved after the introduction of the automatic alert system; however, the HBView project proved useful in reinforcing the automatic alert system.
authors.affiliation: Department of Pharmacy, Nagoya City University Hospital, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan ; Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, 3-1, Tanabe-dori, Mizuho-ku, Nagoya 467-8603 Japan.
authors.forename: Akimasa
authors.initials: A
authors.lastname: Sanagawa
authors.affiliation: Department of Pharmacy, Nagoya City University Hospital, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan ; Department of Clinical Pharmacy, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Kuroda
authors.affiliation: Department of Pharmacy, Nagoya City University Hospital, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan ; Department of Clinical Pharmacy, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan.
authors.forename: Arufumi
authors.initials: A
authors.lastname: Shiota
authors.affiliation: Department of Pharmacy, Nagoya City University Hospital, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Kito
authors.affiliation: Department of Pharmacy, Nagoya City University Hospital, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Takemoto
authors.affiliation: Department of Pharmacy, Nagoya City University Hospital, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan ; Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, 3-1, Tanabe-dori, Mizuho-ku, Nagoya 467-8603 Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kawade
authors.affiliation: Department of Pharmacy, Nagoya City University Hospital, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan ; Department of Clinical Pharmacy, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Esaki
authors.affiliation: Department of Pharmacy, Nagoya City University Hospital, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan ; Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, 3-1, Tanabe-dori, Mizuho-ku, Nagoya 467-8603 Japan ; Department of Clinical Pharmacy, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kimura
keywords: Cancer chemotherapy; Computer-assist system; HBV reactivation; Pharmacist intervention
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