TABLE II.
Summary of responses from the qualitative interviews
| Is testing for hepatitis B surface antigen (hbsag) important? | |
| Oncologist 1 | Yes, because it can prevent reactivation hepatitis, which can be fatal, but only for patients who have risk factors for hepatitis B. |
| Oncologist 2 | Important only for hematologic tumours, not for solid tumours. |
| Oncologist 3 | Yes, because it can prevent something that is potentially fatal. |
| Hematologist | Yes, because it can prevent something that is potentially fatal. |
| Pharmacist | |
| Outpatient | Yes, because it can prevent reactivation hepatitis. |
| Inpatient | Yes, because it can prevent reactivation hepatitis. |
| Challenges inhbsag testing? | |
| Oncologist 1 | Results not returned in time, or test ordered but not done. |
| Oncologist 2 | Cost-effectiveness (no hepatitis B reactivation in solid tumours seen in 15 years of practice). |
| Oncologist 3 | Remembering to test before starting a patient on chemotherapy. |
| Hematologist | None identified (always tests for hbsag before chemotherapy in hematologic cancers). |
| Pharmacist | |
| Outpatient | Test not ordered by the oncologists. |
| Inpatient | Remembering to check whether testing was done, especially if patient is sick. |
| Implement an automatic or standard order forhbsag testing? | |
| Oncologist 1 | No, because if a patient lacks risk factors for hepatitis B, then testing is not needed. |
| Oncologist 2 | Not at this point, because testing may not be cost-effective. |
| Oncologist 3 | Yes, it would be useful. |
| Hematologist | Not necessary |
| Pharmacist | |
| Outpatient | Yes, because no further reminders for checking are needed. |
| Inpatient | Yes, because testing would not be missed. |
| Other strategies to increase the frequency ofhbsag testing? | |
| Oncologist 1 | More checks needed at the nursing and pharmacy levels in the process of testing. |
| Oncologist 2 | More convincing data are needed to show that hepatitis B testing is cost-effective. |
| Oncologist 3 | Automated testing before chemotherapy start. |
| Hematologist | Checklist to remind whether hepatitis B testing was done. |
| Pharmacist | |
| Outpatient | No additional strategies identified. |
| Inpatient | Implement a chemotherapy flow sheet inquiring about hbsag on the inpatient unit. |
| Previous experience with hepatitis B reactivation hepatitis? | |
| Oncologist 1 | No |
| Oncologist 2 | No |
| Oncologist 3 | No |
| Hematologist | Patient with lymphoma developed fulminant hepatic failure from hepatitis B reactivation. |
| Pharmacist | |
| Outpatient | No |
| Inpatient | No |