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Granulocyte colony-stimulating factor use in a large British hospital: comparison with published experience.

Pérez Velasco R - Pharm Pract (Granada) (2010)

Bottom Line: The overall level of compliance with the audit criteria was 72.1%.The results for primary and secondary prophylaxis would have been different if FEC100 (fluorouracil, epirubicin, cyclophosphamide) and docetaxel 100 mg/m (2) had been considered a single chemotherapy regimen.Also, the lack of access to medical notes may have affected the reliability of the results for 'therapeutic' use.

View Article: PubMed Central - PubMed

Affiliation: Research Assistant, Health Intervention and Technology Assessment Program. Department of Health, Ministry of Public Health. Nonthaburi ( Thailand ).

ABSTRACT

Unlabelled: Granulocyte colony-stimulating factors (G-CSF) are high-cost agents recommended as prophylaxis of febrile neutropenia or as adjunctive treatment of severe neutropenic sepsis. Their use in high-risk situations such as acute myeloid leukaemia, acute lymphocytic leukaemia, myelodysplastic syndrome and stem cell transplantation is also indicated.

Objective: This audit assessed the use of G-CSF within the Oncology and Haematology Service Delivery Unit at Guy's and St. Thomas' hospital (London, United Kingdom).

Methods: Patients who received G-CSF in April-May 2008 were identified retrospectively from the pharmacy labelling system, and chemotherapy front sheets, clinic letters and transplantation protocols were reviewed. Patients on lenograstim, in clinical trials or under non-approved chemotherapy protocols were excluded.

Results: A total of 104 G-CSF treatments were assessed. The most commonly treated malignancy was breast cancer (41.3%), with docetaxel 100 mg/m (2) (34.6%) being the most frequent chemotherapy regimen. The chemotherapy intent was curative in 66.3 % of cases. Pegfilgrastim was used in 73.1 % of cases and primary prophylaxis was the most common indication (54.8%). Stem cell transplantation was the first indication to meet the audit criterion (93.3%), followed by primary prophylaxis (89.5%). There was a considerable nonadherence for secondary prophylaxis (6.7%).

Conclusion: The overall level of compliance with the audit criteria was 72.1%. The results for primary and secondary prophylaxis would have been different if FEC100 (fluorouracil, epirubicin, cyclophosphamide) and docetaxel 100 mg/m (2) had been considered a single chemotherapy regimen. Also, the lack of access to medical notes may have affected the reliability of the results for 'therapeutic' use.

No MeSH data available.


Related in: MedlinePlus

Selection of G-CSF treatments † included in analysis
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Figure 1: Selection of G-CSF treatments † included in analysis

Mentions: One hundred and twenty-nine patients that were dispensed G-CSF were identified through thepharmacy labelling system. One hundred and thirteen patients met the inclusion criteria for thestudy. This resulted in 120 independent G-CSF treatments. However, chemotherapy front sheets couldnot be obtained for 16 patients, which reduced the number of valid treatments to 104 (Figure 1). Two factors may explain these missing patient records: (a)patients were included in clinical trials and, therefore, their records were kept in a‘blind’ clinical trial folder; and (b) patients were not receiving chemotherapy, thustheir information was not recorded in chemotherapy front sheets.


Granulocyte colony-stimulating factor use in a large British hospital: comparison with published experience.

Pérez Velasco R - Pharm Pract (Granada) (2010)

Selection of G-CSF treatments † included in analysis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127058&req=5

Figure 1: Selection of G-CSF treatments † included in analysis
Mentions: One hundred and twenty-nine patients that were dispensed G-CSF were identified through thepharmacy labelling system. One hundred and thirteen patients met the inclusion criteria for thestudy. This resulted in 120 independent G-CSF treatments. However, chemotherapy front sheets couldnot be obtained for 16 patients, which reduced the number of valid treatments to 104 (Figure 1). Two factors may explain these missing patient records: (a)patients were included in clinical trials and, therefore, their records were kept in a‘blind’ clinical trial folder; and (b) patients were not receiving chemotherapy, thustheir information was not recorded in chemotherapy front sheets.

Bottom Line: The overall level of compliance with the audit criteria was 72.1%.The results for primary and secondary prophylaxis would have been different if FEC100 (fluorouracil, epirubicin, cyclophosphamide) and docetaxel 100 mg/m (2) had been considered a single chemotherapy regimen.Also, the lack of access to medical notes may have affected the reliability of the results for 'therapeutic' use.

View Article: PubMed Central - PubMed

Affiliation: Research Assistant, Health Intervention and Technology Assessment Program. Department of Health, Ministry of Public Health. Nonthaburi ( Thailand ).

ABSTRACT

Unlabelled: Granulocyte colony-stimulating factors (G-CSF) are high-cost agents recommended as prophylaxis of febrile neutropenia or as adjunctive treatment of severe neutropenic sepsis. Their use in high-risk situations such as acute myeloid leukaemia, acute lymphocytic leukaemia, myelodysplastic syndrome and stem cell transplantation is also indicated.

Objective: This audit assessed the use of G-CSF within the Oncology and Haematology Service Delivery Unit at Guy's and St. Thomas' hospital (London, United Kingdom).

Methods: Patients who received G-CSF in April-May 2008 were identified retrospectively from the pharmacy labelling system, and chemotherapy front sheets, clinic letters and transplantation protocols were reviewed. Patients on lenograstim, in clinical trials or under non-approved chemotherapy protocols were excluded.

Results: A total of 104 G-CSF treatments were assessed. The most commonly treated malignancy was breast cancer (41.3%), with docetaxel 100 mg/m (2) (34.6%) being the most frequent chemotherapy regimen. The chemotherapy intent was curative in 66.3 % of cases. Pegfilgrastim was used in 73.1 % of cases and primary prophylaxis was the most common indication (54.8%). Stem cell transplantation was the first indication to meet the audit criterion (93.3%), followed by primary prophylaxis (89.5%). There was a considerable nonadherence for secondary prophylaxis (6.7%).

Conclusion: The overall level of compliance with the audit criteria was 72.1%. The results for primary and secondary prophylaxis would have been different if FEC100 (fluorouracil, epirubicin, cyclophosphamide) and docetaxel 100 mg/m (2) had been considered a single chemotherapy regimen. Also, the lack of access to medical notes may have affected the reliability of the results for 'therapeutic' use.

No MeSH data available.


Related in: MedlinePlus