Document Detail

Growth factor usage patterns and outcomes in the community setting: collection through a practice-based computerized clinical information system.
MedLine Citation:
PMID:  10764438     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Although use of colony-stimulating factor (CSF) is widespread and guidelines for use have been disseminated, actual practice patterns of medical oncologists are unknown. The purpose of this study was to collect these data using an office-based computerized clinical information system. PATIENTS AND METHODS: Data were collected on patients at 10 community-based oncology practices. Information regarding CSF use was captured at the time of prescribing through a computerized clinical support tool and stored in a data warehouse, and an analysis was carried out retrospectively. RESULTS: A total of 6,813 cancer regimens administered to 5,034 patients were evaluated for growth factor use. Overall, CSFs were used in 14% of regimens, with breast, lymphoma, lung, and ovarian being the most common cancers for which CSFs were used. In 49.4% of regimens, CSF was initiated during cycle 1, with an average duration of 1 week, and was used in two or three cycles per regimen. Afebrile neutropenia is rarely followed by CSF initiation. Granulocyte colony-stimulating factor (G-CSF) is associated with fewer dose adjustments, delays, and hospitalizations when compared with granulocyte-macrophage colony stimulating factor (GM-CSF). There is wide variation among oncologists in CSF use, and several substantial differences were noted between the prescribing behavior of American Society of Clinical Oncology (ASCO) survey-reported oncologists and actual clinical practice, as captured by the computerized clinical information system. CONCLUSION: Computerized clinical information systems can collect detailed information regarding practice patterns of medical oncologists. ASCO physician practice survey data do not accurately reflect actual practice patterns and must be interpreted with caution. Substantial deviations from ASCO growth factor guidelines remain, and oncologists' use of CSFs demonstrates wide variation. There may be important clinical differences between G-CSF and GM-CSF, but definitive phase III trials are needed for confirmation.
G Swanson; K Bergstrom; E Stump; T Miyahara; E T Herfindal
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  18     ISSN:  0732-183X     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-05-18     Completed Date:  2000-05-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1764-70     Citation Subset:  IM    
OnCare Inc, Atlanta, GA, USA.
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MeSH Terms
Antineoplastic Agents / therapeutic use
Drug Utilization
Granulocyte Colony-Stimulating Factor / therapeutic use*
Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use*
Information Systems*
Leukocyte Count
Medical Oncology
Medical Records Systems, Computerized
Neoplasms / blood,  therapy*
Physician's Practice Patterns*
Retrospective Studies
Reg. No./Substance:
0/Antineoplastic Agents; 143011-72-7/Granulocyte Colony-Stimulating Factor; 83869-56-1/Granulocyte-Macrophage Colony-Stimulating Factor
Comment In:
J Clin Oncol. 2000 Sep 15;18(18):3321-2   [PMID:  10986068 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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