Choosing wisely recommendations regarding the top five list of procedures to avoid in the treatment of viral hepatitis: A position statement from the Brazilian Society of Hepatology endorsed by the Latin American Association for the Study of the liver
Introduction and Objectives: The Choosing Wisely (CW) initiative aims to improve daily practice supported by evidence concerning unnecessary medical tests, procedures, and treatments. This philosophy is essential in managing viral hepatitis (VH), which primary care physicians increasingly carry out....
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268122001065 |
| _version_ | 1828071623308083200 |
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| author | Cristiane A. Villela-Nogueira Maria Lúcia Gomes Ferraz Mário Guimarães Pessoa Francisco José Dutra Souto Letícia Cancella Nabuco Henrique Sérgio Moraes Coelho Ezequiel Ridruejo Marcelo Silva Paulo Lisboa Bittencourt Carlos Eduardo Brandão-Mello |
| author_facet | Cristiane A. Villela-Nogueira Maria Lúcia Gomes Ferraz Mário Guimarães Pessoa Francisco José Dutra Souto Letícia Cancella Nabuco Henrique Sérgio Moraes Coelho Ezequiel Ridruejo Marcelo Silva Paulo Lisboa Bittencourt Carlos Eduardo Brandão-Mello |
| author_sort | Cristiane A. Villela-Nogueira |
| collection | DOAJ |
| description | Introduction and Objectives: The Choosing Wisely (CW) initiative aims to improve daily practice supported by evidence concerning unnecessary medical tests, procedures, and treatments. This philosophy is essential in managing viral hepatitis (VH), which primary care physicians increasingly carry out. It is also essential to achieving disease elimination. Thus, the aim of our study was to propose evidence-based CW recommendations in VH. Materials and Methods: The Brazilian Society of Hepatology (SBH) formed a panel of experts in VH who selected evidence-based CW recommendations, which were subsequently scrutinized and ranked by all members of SBH using a web-based approach. Results: Five recommendations were chosen in order of importance: 1) do not order anti-HCV testing after achieving sustained virological response; 2) do not request serial HCV viral load to evaluate HCV progression, 3) do not add ribavirin to direct-acting antivirals in non-cirrhotic, naïve HCV patients; 4) do not screen for hepatocellular carcinoma in HCV patients with none to moderate fibrosis (≤ F2); 5) do not request anti-HBs after HBV vaccination, except for children born to HBV-infected mothers, hemodialysis patients, healthcare professionals, people who have had sexual contact with chronic HBV carriers, HIV-positive persons and immunocompromised individuals (hematopoietic stem-cell transplant recipients or persons receiving chemotherapy). Conclusions: CW recommendations may help general practitioners adopt a more rational and cost-effective approach in managing patients with VH in Brazil and Latin America, leading to lesser waste or harm to patients. |
| first_indexed | 2024-04-11T00:55:43Z |
| format | Article |
| id | doaj.art-ab472c56df224017b7416ecace433497 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-11T00:55:43Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-ab472c56df224017b7416ecace4334972023-01-05T04:31:43ZengElsevierAnnals of Hepatology1665-26812023-01-01281100764Choosing wisely recommendations regarding the top five list of procedures to avoid in the treatment of viral hepatitis: A position statement from the Brazilian Society of Hepatology endorsed by the Latin American Association for the Study of the liverCristiane A. Villela-Nogueira0Maria Lúcia Gomes Ferraz1Mário Guimarães Pessoa2Francisco José Dutra Souto3Letícia Cancella Nabuco4Henrique Sérgio Moraes Coelho5Ezequiel Ridruejo6Marcelo Silva7Paulo Lisboa Bittencourt8Carlos Eduardo Brandão-Mello9Faculdade de Medicina, Departamento de Clínica Médica e Serviço de Hepatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brazil; Corresponding author.Disciplina de Gastroenterologia, Universidade Federal de São Paulo, BrazilDivisão de Gastroenterologia e Hepatologia, Hospital das Clínicas da Universidade de São Paulo, BrazilDepartamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Mato Grosso, Mato Grosso, BrazilServiço de Hepatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, BrazilFaculdade de Medicina, Departamento de Clínica Médica e Serviço de Hepatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, BrazilSección Hepatologia, Departamento de Medicina, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, “CEMIC”, Ciudad Autónoma de Buenos Aires, ArgentinaDepartamento de Desarollo Académico del Hospital Universitário Austral, Buenos Aires, ArgentinaHospital Português, e Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, BrazilHospital Universitário Gaffrée e Guinle, Escola de Medicina e Cirurgia da Universidade do Rio de Janeiro, BrazilIntroduction and Objectives: The Choosing Wisely (CW) initiative aims to improve daily practice supported by evidence concerning unnecessary medical tests, procedures, and treatments. This philosophy is essential in managing viral hepatitis (VH), which primary care physicians increasingly carry out. It is also essential to achieving disease elimination. Thus, the aim of our study was to propose evidence-based CW recommendations in VH. Materials and Methods: The Brazilian Society of Hepatology (SBH) formed a panel of experts in VH who selected evidence-based CW recommendations, which were subsequently scrutinized and ranked by all members of SBH using a web-based approach. Results: Five recommendations were chosen in order of importance: 1) do not order anti-HCV testing after achieving sustained virological response; 2) do not request serial HCV viral load to evaluate HCV progression, 3) do not add ribavirin to direct-acting antivirals in non-cirrhotic, naïve HCV patients; 4) do not screen for hepatocellular carcinoma in HCV patients with none to moderate fibrosis (≤ F2); 5) do not request anti-HBs after HBV vaccination, except for children born to HBV-infected mothers, hemodialysis patients, healthcare professionals, people who have had sexual contact with chronic HBV carriers, HIV-positive persons and immunocompromised individuals (hematopoietic stem-cell transplant recipients or persons receiving chemotherapy). Conclusions: CW recommendations may help general practitioners adopt a more rational and cost-effective approach in managing patients with VH in Brazil and Latin America, leading to lesser waste or harm to patients.http://www.sciencedirect.com/science/article/pii/S1665268122001065Care qualityVaccineVirusRecommendationsHCVHBV |
| spellingShingle | Cristiane A. Villela-Nogueira Maria Lúcia Gomes Ferraz Mário Guimarães Pessoa Francisco José Dutra Souto Letícia Cancella Nabuco Henrique Sérgio Moraes Coelho Ezequiel Ridruejo Marcelo Silva Paulo Lisboa Bittencourt Carlos Eduardo Brandão-Mello Choosing wisely recommendations regarding the top five list of procedures to avoid in the treatment of viral hepatitis: A position statement from the Brazilian Society of Hepatology endorsed by the Latin American Association for the Study of the liver Annals of Hepatology Care quality Vaccine Virus Recommendations HCV HBV |
| title | Choosing wisely recommendations regarding the top five list of procedures to avoid in the treatment of viral hepatitis: A position statement from the Brazilian Society of Hepatology endorsed by the Latin American Association for the Study of the liver |
| title_full | Choosing wisely recommendations regarding the top five list of procedures to avoid in the treatment of viral hepatitis: A position statement from the Brazilian Society of Hepatology endorsed by the Latin American Association for the Study of the liver |
| title_fullStr | Choosing wisely recommendations regarding the top five list of procedures to avoid in the treatment of viral hepatitis: A position statement from the Brazilian Society of Hepatology endorsed by the Latin American Association for the Study of the liver |
| title_full_unstemmed | Choosing wisely recommendations regarding the top five list of procedures to avoid in the treatment of viral hepatitis: A position statement from the Brazilian Society of Hepatology endorsed by the Latin American Association for the Study of the liver |
| title_short | Choosing wisely recommendations regarding the top five list of procedures to avoid in the treatment of viral hepatitis: A position statement from the Brazilian Society of Hepatology endorsed by the Latin American Association for the Study of the liver |
| title_sort | choosing wisely recommendations regarding the top five list of procedures to avoid in the treatment of viral hepatitis a position statement from the brazilian society of hepatology endorsed by the latin american association for the study of the liver |
| topic | Care quality Vaccine Virus Recommendations HCV HBV |
| url | http://www.sciencedirect.com/science/article/pii/S1665268122001065 |
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