Patient and physician characteristics associated with erythropoiesis-stimulating agent use in patients with myelodysplastic syndromes.
Patient and physician characteristics associated with use of erythropoiesis-stimulating agents in myelodysplastic syndrome patients have not yet been described. Myelodysplastic syndrome patients diagnosed from 2001 to 2005 were identified from the Surveillance Epidemiology and End Results-Medicare database. Multivariate regressions examined the association between patient and physician characteristics and the probability of receiving any erythropoiesis-stimulating agents, and of receiving therapeutic-length (≥ 8 week) treatment episodes. Among the 6,588 myelodysplastic syndrome patients studied, 65% received erythropoiesis-stimulating agents. Use of erythropoiesis-stimulating agents was lower for blacks compared to whites (OR 0.78; 95% CI:0.61-0.99), single persons compared to married (OR 0.77; 95% CI:0.62-0.97), Medicaid recipients (OR 0.66; 95% CI:0.55-0.79), and those living in census tracts with lower educational attainment. Patients who did not consult a hematology-oncology specialist were less likely to receive erythropoiesis-stimulating agents. Specialist access, financial resources and mobility are key determinants of receipt of erythropoiesis-stimulating agents among myelodysplastic syndrome patients.
Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland 21201, USA. adavidof@rx.umaryland.edu
Amy J
AJ
Davidoff
Sheila
S
Weiss Smith
Maria R
MR
Baer
Xuehua
X
Ke
Jason M
JM
Bierenbaum
Franklin
F
Hendrick
Diane L
DL
McNally
Steven D
SD
Gore
D000368:Aged; D000369:Aged, 80 and over; D015981:Epidemiologic Factors; D005260:Female; D006397:Hematinics / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000453:epidemiology*; D010819:Physician's Role; D018426:SEER Program
D006397:Hematinics