“Same-Day” administration of pegfilgrastim following myelosuppressive chemotherapy: clinical practice and provider rationale

Abstract

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). 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. 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. 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.

DOI: 10.1007/s00520-016-3193-3

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Cite this paper

@article{Marion2016SameDayAO, title={“Same-Day” administration of pegfilgrastim following myelosuppressive chemotherapy: clinical practice and provider rationale}, author={Sarah Deboard Marion and Spiros Tzivelekis and Christina Darden and Mark Price and Bintu N. Sherif and Jacob Garcia and James A. Kaye and David B. Chandler}, journal={Supportive Care in Cancer}, year={2016}, volume={24}, pages={3889-3896} }