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Growth factor usage patterns and outcomes in the community setting: collection through a practice-based computerized
G Swanson1, K Bergstrom, E Stump
1OnCare Inc, Atlanta, GA, USA.
Summary
Medical oncologists show wide variation in colony-stimulating factor (CSF) use, deviating from guidelines. Computerized systems reveal practice patterns differ from surveys, highlighting the need for more research on G-CSF versus GM-CSF.
Area of Science:
- Oncology
- Hematology
- Clinical Practice Research
Background:
- Colony-stimulating factors (CSFs) are widely used in cancer treatment.
- Existing guidelines for CSF use have been disseminated to medical oncologists.
- Actual practice patterns of medical oncologists regarding CSF use remain largely unknown.
Purpose of the Study:
- To collect data on the actual practice patterns of medical oncologists concerning CSF use.
- To utilize an office-based computerized clinical information system for data collection.
- To compare actual practice patterns with reported behaviors and guidelines.
Main Methods:
- Data collected retrospectively from 10 community-based oncology practices.
- CSF use captured at the time of prescribing via a computerized clinical support tool.
- Analysis of 6,813 cancer regimens administered to 5,034 patients.
Main Results:
- CSFs were used in 14% of cancer regimens, most commonly in breast, lymphoma, lung, and ovarian cancers.
- CSF initiation often occurred in cycle 1 (49.4%), with an average duration of 1 week over two or three cycles.
- Granulocyte colony-stimulating factor (G-CSF) showed associations with fewer adverse events (dose adjustments, delays, hospitalizations) compared to granulocyte-macrophage colony stimulating factor (GM-CSF).
- Significant variation in CSF prescribing among oncologists was observed.
- Actual clinical practice, captured by the system, differed substantially from ASCO survey-reported behaviors.
Conclusions:
- Computerized clinical information systems effectively capture detailed oncologists' practice patterns.
- ASCO physician practice survey data may not accurately reflect real-world clinical practice.
- Significant deviations from ASCO growth factor guidelines persist, with considerable variation in CSF use.
- Further Phase III trials are necessary to confirm potential clinical differences between G-CSF and GM-CSF.