The use of granulocyte colony-stimulating factors in a Canadian outpatient setting.
BACKGROUND
Data on real-life utilization of granulocyte colony-stimulating factors (g-csfs) in Canada are limited. The objective of the present study was to describe the reasons for, and the patterns of, g-csf use in selected outpatient oncology clinics in Ontario and Quebec.


METHODS
In a retrospective longitudinal cohort study, a review of medical records from 9 Canadian oncology clinics identified patients being prescribed filgrastim (fil) and pegfilgrastim (peg). Patient characteristics, reasons for g-csf use, and treatment patterns were descriptively analyzed.


RESULTS
Medical records of 395 patients initiating g-csf therapy between January 2008 and January 2009 were included. Of this population, 80% were women, and breast cancer was the predominant diagnosis (59%). The most commonly prescribed g-csf was fil (56% in Ontario and 98% in Quebec). The most frequent reason for g-csf use was primary prophylaxis (42% for both fil and peg), followed by secondary prophylaxis (37% fil, 41% peg). Those proportions varied by tumour type and chemotherapy regimen. Delayed g-csf administration (more than 1 day after the end of chemotherapy) was frequently observed for fil, but rarely reported for peg, and that finding was consistent across tumours and concurrent chemotherapy regimens.


CONCLUSIONS
The use of g-csf varies with the malignancy type and the provincial health care setting. The most commonly prescribed g-csf agent was fil, and most first g-csf prescriptions were for primary prophylaxis. Delays were frequently observed for patients receiving fil, but were rarely reported for those receiving peg.
Peel Regional Cancer Centre, Credit Valley Hospital, Mississauga, ON.
S
S
Fine
Health Outcomes and Pharmacoeconomic (HOPE) Research Centre, Sunnybrook Research Institute, Toronto, ON.
M
M
Koo
OptumInsight, Burlington, ON.
T
T
Gill
OptumInsight, Burlington, ON.
M
M
Marin
Amgen, Thousand Oaks, CA, U.S.A.
M
M
Poulin-Costello
Amgen, Thousand Oaks, CA, U.S.A.
R
R
Barron
Health Outcomes and Pharmacoeconomic (HOPE) Research Centre, Sunnybrook Research Institute, Toronto, ON. ; Department of Pharmacology, University of Toronto, Toronto, ON.
N
N
Mittmann
Neutropenia; colony-stimulating factors; filgrastim; outcomes; pegfilgrastim; prophylaxis