News in brief: Education for IBD in pregnancy; Hepascore rejected for MBS reimbursement; GESA guidance on COVID-19 vaccine

Thursday, 18 Mar 2021

Gastroenterologists educate women on IBD in pregnancy

Dr Emma Flanagan

Pregnancy A gastroenterologist-led educational intervention can help improve pregnancy outcomes for women with IBD, clinicians in Victoria have shown.

The impact of an individualised education program in 100 women with IBD who were pregnant or planning pregnancy was assessed by Dr Emma Flanagan and colleague who run the Preconception and Pregnancy IBD specialised clinic at St. Vincent’s Hospital, Melbourne

Prior to the intervention 32% of women had poor knowledge of IBD and pregnancy, which was reduced to 5% after the intervention. The education program also resulted in significant improvements in Crohn’s and Colitis Pregnancy Knowledge scores, anxiety and depression and quality of life scores, as well as adherence rates to medications such as infliximab.

The results are published in Inflammatory Bowel Diseases.

Hepascore rejected  for MBS reimbursement

A bid for Medicare reimbursement for Hepascore to diagnose and monitor liver fibrosis in patients with hepatitis B or C has been rejected by the Medicare Service Advisory Committee (MSAC) .

In response to an application by Professor Gary Jeffrey, a hepatologist at Sir Charles Gairdner Hospital, Perth, MSAC said there were already many other tests for liver fibrosis and Hepascore would not add any additional clinical value. The committee said a positive result indicative of fibrosis or cirrhosis would likely be confirmed with additional testing due to Hepascore’s low positive predictive value. It also noted that the AST to platelet ratio index (APRI) is calculated from routine monitoring tests and has similar specificity to Hepascore at a threshold of 2, meaning it can rule out cirrhosis as effectively as Hepascore. Hepascore might have value in rural areas where access to transient elastography (Fibroscan was limited access, MSAC acknowledged.

GESA guidance on COVID-19 vaccinations

People with GI and liver disease are recommended to have COVID-19 vaccination wherever possible, according to new guidance released by GESA.

The advice states that the vaccines available in Australia are considered safe and effective and recommended for patients experiencing and taking medication for: IBD, liver disease and liver transplantation.

However, patients who are taking more than 10mg of prednisolone daily or rituximab are advised to talk to their clinician about the timing of vaccination.

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