After pharmacists began adding progress notes recommending hepatitis B virus (HBV) screening for patients initiating the oral anticancer agents ibrutinib or imatinib, screening rates in the hematology/oncology department at VA Northeast Ohio Healthcare System increased from 38% to 78%, according to research presented at the Association of VA Hematology/Oncology (AVAHO) Annual Meeting.

“Previous recommendations for HBV screening in cancer patients were limited to patients initiating treatment with a high risk of reactivation, such as anti-CD20 monoclonal antibodies,” researchers explained in the abstract background. However, “reports of HBV reactivation with other anticancer agents have been published. In July 2020, the American Society of Clinical Oncology published a provisional clinical opinion update suggesting all patients initiating systemic anticancer therapy be screened for HBV.”

In April 2021, VA Northeast Ohio Healthcare System implemented a process in which new orders for anticancer medications were reviewed by pharmacists. If patients did not have HBV screening, pharmacists recommending the screening in a progress note.

Baseline data in July 2020 showed that 38% of patients with an active prescription for ibrutinib or imatinib had been screened prior to initiation of the medication. An analysis for April 2021 and May 2021 found that 18 of the 23 patients initiating the anticancer agents, or 78%, had received HBV screening.

Of the 18 patients, five had screenings ordered by a hematologist/oncologist when the anticancer drugs were prescribed. Pharmacists entered progress notes for all 18 patients, 13 of whom subsequently had HBV screening ordered.

HBV screening revealed two patients at risk for HBV reactivation and prompted the initiation of close monitoring, according to the poster. HBV reactivation, potentially due to anticancer therapy, was identified in one patient.

“Pharmacists can play a role in tracking patients initiating anticancer therapy and ensure HBV screening is completed,” the abstract advised.

Reference:

Veide A. Hepatitis B virus screening when initiating oral anticancer therapy. Abstract presented at Association of VA Hematology/Oncology (AVAHO) Annual Meeting; September 24-26, 2021.