Abstract
Purpose
To describe patient- and practice-related factors that physicians report affect their clinical decision to administer prophylactic pegfilgrastim to patients <24 h after completion of a myelosuppressive chemotherapy cycle (i.e., “same-day” pegfilgrastim).
Methods
Oncologists, hematologists, and hematologist-oncologists enrolled in a US national physician panel were invited to participate in a cross-sectional, web-based survey to assess physicians’ reasons for prescribing “same-day” pegfilgrastim. Physicians were screened as eligible if they reported prescribing “same-day” pegfilgrastim within the previous 6 months. The survey assessed physician perspectives and physician-perceived patient/caregiver preferences.
Results
Of 17,478 invited physicians, 386 answered the screening questions; 151 (39.1 %) were eligible, agreed to participate, and completed the survey. Physicians estimated that overall 41.3 % of their patients treated with myelosuppressive chemotherapy received pegfilgrastim and that 31.6 % treated with pegfilgrastim received it on a “same-day” schedule. Approximately 36 % of physicians relied primarily on their clinical judgment when deciding to administer “same-day” pegfilgrastim. The clinical consideration reported most commonly by physicians as moderately or very important when deciding to administer “same-day” pegfilgrastim was previous febrile neutropenia (77.6 %). The most important patient-related consideration in the decision to administer “same-day” pegfilgrastim was patient/caregiver travel distance, and the most important practice-related consideration was the burden to the physician’s practice of “next-day” administration (vs. same-day), reported by 84.7 % and 65.1 % of physicians as moderately or very important, respectively.
Conclusions
While clinical judgment, patients’ risk factors, and practice burden were principal influences favoring “same-day” pegfilgrastim administration, physician-perceived patient preferences and logistical barriers also have important roles in this decision.
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Acknowledgments
The authors take full responsibility for the content of the paper. Ms. Marion was an employee of RTI Health Solutions during the time the study was conducted. The authors thank Kimberly Davis, MS and Kelly Hollis, MBA (RTI Health Solutions) for their assistance. The authors wish to extend a special thanks to Allen Mangel, MD, PhD (RTI Health Solutions), for provision of technical and scientific guidance while developing the manuscript.
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Amgen, Inc.
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Marion, S., Tzivelekis, S., Darden, C. et al. “Same-Day” administration of pegfilgrastim following myelosuppressive chemotherapy: clinical practice and provider rationale. Support Care Cancer 24, 3889–3896 (2016). https://doi.org/10.1007/s00520-016-3193-3
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DOI: https://doi.org/10.1007/s00520-016-3193-3