title: Filgrastim use in the emergency department of a Spanish general hospital.
abstract: BACKGROUND
  Febrile neutropenia is a cause of dose reduction in hematological cancer treatments, with patient risk of infection proportional to duration and severity. In addition, colony-stimulating factors have been shown to be beneficial in a patient subgroup, although they are probably overused in the clinical setting.
  
  
  OBJECTIVE
  Evaluation of compliance with American Society of Clinical Oncology 2006 criteria when it comes to filgrastim use in the Emergency Department of a Spanish general hospital.
  
  
  METHODS
  A prospective observational study from August 2011 to February 2012 in a tertiary Spanish General Hospital. We included all patients prescribed with filgrastim in the Emergency Department. Data was collected on demographics, the pharmacotherapy history, the administered chemoprophylaxis, and the destination after discharge from a clinical department, the complete blood count, and the presence of fever >= 38 °C.
  
  
  RESULTS
  51 patients were recorded over the period of the study. 27.45% of prescriptions complied with the clinical practice guideline criteria given the risk of febrile neutropenia, whereas 72.34% of prescriptions did not comply with the criteria, 17.65% of which did not fulfil any requirements.
  
  
  CONCLUSIONS
  A high percentage of colony-stimulating factors use in the Emergency Department does not comply with the medical practice guideline.
authors.forename: Francisco José
authors.initials: FJ
authors.lastname: Rodríguez-Lucena
authors.forename: Leticia
authors.initials: L
authors.lastname: Soriano-Irigaray
authors.forename: Carmen
authors.initials: C
authors.lastname: Matoses-Chirivella
authors.forename: Inmaculada P
authors.initials: IP
authors.lastname: Jiménez-Pulido
authors.forename: José M
authors.initials: JM
authors.lastname: del Moral-Sánchez
authors.forename: Maria
authors.initials: M
authors.lastname: Morante-Hernández
authors.forename: Andrés
authors.initials: A
authors.lastname: Navarro-Ruiz
mesh_terms: D017723:Drug Utilization Review; D004636:Emergency Service, Hospital / Q000592:standards; D064147:Febrile Neutropenia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019983:Guideline Adherence; D006769:Hospitals, General / Q000592:standards; D006785:Hospitals, University / Q000592:standards; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D057970:Inappropriate Prescribing; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D013030:Spain
chemical_list: D007155:Immunologic Factors; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim