title: G-CSF utilization rate and prescribing patterns in United States: associations between physician and patient factors and GCSF use.
abstract: Febrile neutropenia (FN) is a common complication among patients with chemotherapy-induced myelotoxicity and is associated with a number of negative outcomes including prolonged hospitalization, increased medical costs, increased risk of mortality, dose reductions, and delays. Granulocyte-colony-stimulating factor (G-CSF), granulocyte-macrophage-colony stimulating factor (GM-CSF), and pegylated G-CSF are effective at reducing risk and duration of neutropenia-related events. However, despite guidelines, the use of G-CSF and pegylated G-CSF in the United States has not been consistent and pattern of care studies have focused primarily on G-CSF. A number of studies found that G-CSF is underutilized in patients undergoing chemotherapy treatments associated with a high risk of FN, while being over utilized in patients with a low-risk FN. Wide variations in overuse, underuse, and misuse of G-CSF are associated with a number of physician and patient factors. Improved awareness of the guidelines, feedback to providers regarding proper usage, and understanding of chemotherapy regimens associated with very low risks as well as high risks (>20%) of FN is some of the approaches that could lead to improving care.
authors.affiliation: Teva Pharmaceuticals, 41 Moores Rd., Frazer, Pennsylvania, 19355.
authors.forename: Gisoo
authors.initials: G
authors.lastname: Barnes
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Pathak
authors.forename: Lee
authors.initials: L
authors.lastname: Schwartzberg
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D004358:Drug Therapy / Q000706:statistics & numerical data; D064147:Febrile Neutropenia / Q000188:drug therapy* / Q000517:prevention & control; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage*; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012307:Risk Factors; D014481:United States
chemical_list: D000970:Antineoplastic Agents; D016178:Granulocyte-Macrophage Colony-Stimulating Factor
keywords: Granulocyte-colony-stimulating factor; mylosupressive chemotherapy; neutropenia