A quasi‐experimental trial of the clinical and economic impact of implementing of hepatitis B immunoglobulin policy post needle stick and sharp injuries in reducing its unnecessary use at a tertiary care hospital

Abstract

SUMMARY Introduction Hepatitis B virus infection has the highest rate of transmission out of the blood‐borne viruses in health care workers. Exposure to HBsAg positive source should be managed based on Hepatitis B serology results. Given that Hepatitis B immunoglobulin (HBIG) is an expensive medication with limited stock levels, it should be given more attention to make sure of its optimum use. This trial aims to evaluate the effectiveness of a policy on the use of HBIG following needle stick and sharp injuries among health care workers. Methods It is a quasi‐experimental trial conducted at a Tertiary Care hospital in Saudi Arabia. The participants were health care workers who received HBIG following needle stick and sharp injuries from January 2018 to May 2020. Before and after implementing departmental guidelines and education on the post‐exposure procedure, the trial re‐evaluated the need for HBIG among the receivers. Results A total of 60 health care workers received HBIG for needle stick and sharp injuries between the trial period (pre‐ and post‐implementation). The percentage of patients who received inappropriate HBIG was significantly lower during the post‐implementation of the guideline (30%) than that among the pre‐implementation period (60%). Thus, the direct cost associated with the inappropriate use was reduced from SAR 30000 to SAR 13500 post‐implementation. Conclusion The implementation of HBIG guidelines of use and education has led to a statistically significant decrease in its inappropriate use and led to cost reduction.

The Application of Focused Care Model in the Management of Hepatitis B Patients in a Tertiary Care Hospital and the Impact on Patients’ Quality of Life

“…Because the disease of diffuse hepatitis is very long and prone to onset, many patients have little understanding of the condition and cannot carry out outpatient follow-up visits, take medicines, and change bad eating habits and living habits according to the medical instructions of medical staff. It can be seen that the efficacy of patients with hepatitis disorders is not ideal, and it is related to the cause of the disease; in addition to the lack of efficient therapeutic drugs, a key that cannot be ignored is the poor compliance of patients [ 11 ].…”

Development of a recombinant hepatitis B immunoglobulin derived from B cells collected from healthy individuals administered with hepatitis B virus vaccines: A feasibility study

“…It was first developed in the 1970s for passive immunization against infection by the hepatitis B virus (HBV) 1,2 . Anti‐virals, such as nucleos(t)ide analogs, are widely used as a treatment for HBV‐related diseases and as prophylactics against HBV reactivation, 3,4 while HBIG is used to prevent mother‐to‐child transmission and for post‐exposure prophylaxis 5–7 . In Japan, HBIG is also approved for use as a prophylactic agent against HBV reactivation during liver transplantations related to HBV infection, where either the recipients or donors are positive for HBV.…”