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Hepatitis B vaccination: addressing a drug-related problem in hemodialysis outpatients with a collaborative

Rowland J Elwell1, Marianne Neumann, Harold J Manley

  • 1Albany College of Pharmacy, Albany, NY, USA.

Nephrology Nursing Journal : Journal of the American Nephrology Nurses' Association
|July 17, 2003
PubMed

Insights

A proactive hepatitis B virus (HBV) vaccination program significantly improved vaccination rates among hemodialysis (HD) patients. This initiative successfully addressed a critical drug-related problem by ensuring all eligible patients received the recommended HBV vaccine.

Area of Science:

  • Nephrology
  • Immunology
  • Public Health

Background:

  • Hemodialysis (HD) patients are at high risk for hepatitis B virus (HBV) infection.
  • Hepatitis B virus (HBV) vaccination is recommended by the CDC for all HD patients.
  • A significant gap existed in HBV vaccination coverage among HD patients, representing a drug-related problem (DRP).

Purpose of the Study:

  • To implement and evaluate a proactive hepatitis B virus (HBV) vaccination program for hemodialysis (HD) patients.
  • To address the identified drug-related problem of inadequate HBV vaccination in HD patients.
  • To improve HBV vaccine uptake and seroprotection rates in this vulnerable population.

Main Methods:

  • Developed an immunization protocol based on CDC recommendations for HBV vaccination (40 mcg intramuscularly at 0, 1, and 6 months).
  • Administered HBV vaccine to consenting HD patients and monitored anti-hepatitis B surface antibody (anti-HBs) titers.
  • Provided booster doses as needed per protocol to achieve protective antibody levels.

Main Results:

  • By August 2001, 100% of consenting HD patients received at least one dose of the HBV vaccine.
  • 81.8% of patients completed the vaccine series or achieved a positive anti-HBs titer (>= 10 mIU/mL).
  • 58% of patients developed a positive anti-HBs titer, with 37% responding to three doses and 21% after a booster dose.

Conclusions:

  • A concerted effort involving nurses and pharmacists can successfully implement HBV vaccination programs in HD settings.
  • Offering HBV vaccine to all HD patients is crucial for preventing hepatitis B virus infection, aligning with CDC guidelines.
  • The proactive vaccination initiative effectively addressed the drug-related problem of low HBV vaccine coverage in hemodialysis patients.
Abstract

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