RESTON, Va.- Twenty million nuclear medicine procedures that detect and evaluate heart disease, brain disorders and cancer-and that use radiopharmaceuticals to treat overactive thyroids and some cancers-are performed each year. While health care providers in many facilities do provide patients with adequate information about nuclear medicine procedures, there's room for improvement, says a study supported by the Centers of Disease Control and Prevention and the Agency for Healthcare Research and Quality that appears in the December Journal of Nuclear Medicine.

"Patients undergoing diagnostic procedures are less likely than patients undergoing therapeutic procedures to be informed that they could activate radiation alarms in public places," said Armin Ansari, a health physicist in the radiation studies branch of the Centers for Disease Control and Prevention in Atlanta, Ga. "We also found that many health care professionals who administer radiopharmaceuticals to patients-or who communicate with them regarding the radiation safety aspects of their procedures-have not had any formal or systematic training in patient education, communications or counseling," he added.

"Before we began the study, casual conversations with patients who received diagnostic procedures (largely stress tests) suggested that many receive neither documentation nor counseling. Some are even unaware that their procedure involved trace amounts of radioactive materials and that they could indeed trigger radiation detection equipment in public places," said Ansari. The study, done in collaboration with the Nuclear Regulatory Commission (NRC), examined the range of patient release procedures and practices among 66 health care facilities in 12 states. Participating facilities perform a range of diagnostic and therapeutic procedures including cardiac stress tests; positron emission tomography (PET), bone, lung and renal scans; thyroid uptake studies; whole body scans; I-131 hyperthyroid treatments; I-131 Bexxar cancer treatments; and brachytherapy. For the study, 89 health care professionals (including doctors, nuclear medicine technologists, radiation safety officers and physicists) were interviewed at large and small hospitals and outpatient-only clinics.
The study indicates that health care professionals-especially in outpatient facilities and those performing only diagnostic procedures-can benefit from an outreach program, detailing the need to inform and counsel all released patients. "Some standardization of basic instructions and documentation given to released patients would also be helpful," said Ansari. "Patients should know the importance of following the instructions given to them by their caregivers. They should feel comfortable asking questions and be forthcoming if there are some instructions they may have difficulty following (such as minimizing time in public). If patients plan to travel, they should make sure they have documentation on hand specifying their procedure and that the documentation includes a contact phone number for verification, if necessary," he explained.

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