Analysis of medical prescribing practices for hepatitis B serology tests

Girard, A.; Moreau–Gaudry, Alexandre; Réseau, Prométhée Alpes; Hilleret, Marie Noelle

doi:10.1016/j.gcb.2009.05.014

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…The studies that reported data included collectively 4111 physicians and 175 563 patients (2 studies did not report the number of physicians, 34,35 and 8 studies did not report the number of patients, 20,22,23,28 –30,32 –34,35 and those numbers were also not available in related papers). There were 20 studies 36 –55 in which outcomes for family physicians were not separable from those of other professional groups, and these were excluded from this review.…”

Section: Resultsmentioning

confidence: 99%

Interventions to Educate Family Physicians to Change Test Ordering

2016

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The purpose is to systematically review randomised controlled trials (RCTs) to change family physicians’ laboratory test-ordering. We searched 15 electronic databases (no language/date limitations). We identified 29 RCTs (4,111 physicians, 175,563 patients). Six studies specifically focused on reducing unnecessary tests, 23 on increasing screening tests. Using Cochrane methodology 48.5% of studies were low risk-of-bias for randomisation, 7% concealment of randomisation, 17% blinding of participants/personnel, 21% blinding outcome assessors, 27.5% attrition, 93% selective reporting. Only six studies were low risk for both randomisation and attrition. Twelve studies performed a power computation, three an intention-to-treat analysis and 13 statistically controlled clustering. Unweighted averages were computed to compare intervention/control groups for tests assessed by >5 studies. The results were that fourteen studies assessed lipids (average 10% more tests than control), 14 diabetes (average 8% > control), 5 cervical smears, 2 INR, one each thyroid, fecal occult-blood, cotinine, throat-swabs, testing after prescribing, and urine-cultures. Six studies aimed to decrease test groups (average decrease 18%), and two to increase test groups. Intervention strategies: one study used education (no change): two feedback (one 5% increase, one 27% desired decrease); eight education + feedback (average increase in desired direction >control 4.9%), ten system change (average increase 14.9%), one system change + feedback (increases 5-44%), three education + system change (average increase 6%), three education + system change + feedback (average 7.7% increase), one delayed testing. The conclusions are that only six RCTs were assessed at low risk of bias from both randomisation and attrition. Nevertheless, despite methodological shortcomings studies that found large changes (e.g. >20%) probably obtained real change.

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Section: Resultsmentioning

confidence: 99%

Interventions to Educate Family Physicians to Change Test Ordering

2016

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“…Knowledge about HBV transmission factors are generally good in these patient groups compared with others [26], yet they have evidenced difficulties in differentiating between negative and immunised statuses [27]. Moreover, general practitioners in France sometimes have difficulty in correctly interpreting HBV serologic results [28], possibly leading to further confusion among these individuals. More fostered education on HBV-status by trained specialists has demonstrated success in increasing understanding of HBV disease in Hmong and Asian/Pacific Islanders in the USA [29, 30] and could be of use in this setting.…”

Section: Discussionmentioning

confidence: 99%

Self-reported patient history to assess hepatitis B virus serological status during a large screening campaign

et al. 2018

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When assessing hepatitis B virus (HBV) status in clinical settings, it is unclear whether self-reports on vaccination history and previous HBV-test results have any diagnostic capacity. Of 3997 participants in a multi-centre HBV-screening study in Paris, France, 1090 were asked questions on their last HBV-test result and vaccination history. Discordance between self-reported history compared with infection status (determined by serology) was calculated for participants claiming ‘negative’, ‘effective vaccine’, ‘past infection’, or ‘chronic infection’ HBV-status. Serological testing revealed that 320 (29.4%) were non-immunised, 576 (52.8%) were vaccinated, 173 (15.9%) had resolved the infection and 21 (1.9%) were hepatitis B surface antigen positive. In total 208/426 (48.8%) participants with a self-reported history of ‘negative’ infection had a discordant serological result, in whom 128 (61.5%) were vaccinated and 74 (35.6%) had resolved infections. A total of 153/599 (25.5%) participants self-reporting ‘effective vaccine’ had a discordant serological result, in whom 100 (65.4%) were non-immunised and 50 (32.7%) were resolved infections. Discordance for declaring ‘past’ or ‘chronic infection’ occurred in 9/55 (16.4%) and 3/10 (30.0%) individuals, respectively. In conclusion, self-reported HBV-status based on participant history is partially inadequate for determining serological HBV-status, especially between negative/vaccinated individuals. More adapted patient education about HBV-status might be helpful for certain key populations.

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Hépatites virales et santé publique

Braillon

Dubois

2010

Gastroentérologie Clinique et Biologique

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Analysis of medical prescribing practices for hepatitis B serology tests

Cited by 4 publications

References 8 publications

Interventions to Educate Family Physicians to Change Test Ordering

Interventions to Educate Family Physicians to Change Test Ordering

Self-reported patient history to assess hepatitis B virus serological status during a large screening campaign

Hépatites virales et santé publique

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