Skip to main content
Journal cover image

Use of erythropoietin in cancer patients: assessment of oncologists' practice patterns in the United States and other countries.

Publication ,  Journal Article
Adams, JR; Elting, LS; Lyman, GH; George, JN; Lembersky, BC; Armitage, JO; Demetri, GD; Bennett, CL
Published in: Am J Med
January 1, 2004

PURPOSE: To assess physician use of erythropoietin in cancer patients before publication of the American Society of Clinical Oncology/American Society of Hematology guidelines. METHODS: Questionnaires about erythropoietin use in practice and 12 hypothetical clinical scenarios involving patients with cancer were mailed to 2000 oncologists/hematologists in the United States and 19 other countries. Response rates were 30% in the United States and 25% internationally. Data on erythropoietin use for ovarian cancer were obtained from one clinical trial. Multivariate regression models assessed predictors of erythropoietin prescription. RESULTS: Most physicians selected a hemoglobin level < or =10 g/dL as an upper threshold for erythropoietin use (36% to 51% of U.S. physicians and 21% to 32% of foreign physicians). Frequent erythropoietin use (defined as use in at least 10% of cancer patients) was higher in the United States than elsewhere (adjusted odds ratio [OR] = 5.8; 95% confidence interval [CI]: 2.5 to 13.4). Among U.S. physicians, those who said they used erythropoietin frequently were more likely to be in fee-for-service than managed care settings (OR = 2.2; 95% CI: 1.3 to 3.7). Those who reported never using erythropoietin practiced in countries that had lower annual per capita health care expenditures, lower proportions of privately funded health care, and a national health service (P <0.05 for all comparisons). Of 235 ovarian cancer patients who received topotecan, 38% (45/118) of U.S. patients and 2% (2/117) of European patients who developed grade 1 anemia (hemoglobin level between 10 and 12 g/dL) were treated with erythropoietin (P <0.01). CONCLUSION: Financial considerations and a hemoglobin level <10 g/dL appear to influence erythropoietin use in the United States, whereas financial considerations alone determine erythropoietin use abroad.

Duke Scholars

Published In

Am J Med

DOI

ISSN

0002-9343

Publication Date

January 1, 2004

Volume

116

Issue

1

Start / End Page

28 / 34

Location

United States

Related Subject Headings

  • United States
  • Topotecan
  • Regression Analysis
  • Practice Patterns, Physicians'
  • Practice Guidelines as Topic
  • Ovarian Neoplasms
  • Odds Ratio
  • Neoplasms
  • Medical Oncology
  • Managed Care Programs
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Adams, J. R., Elting, L. S., Lyman, G. H., George, J. N., Lembersky, B. C., Armitage, J. O., … Bennett, C. L. (2004). Use of erythropoietin in cancer patients: assessment of oncologists' practice patterns in the United States and other countries. Am J Med, 116(1), 28–34. https://doi.org/10.1016/j.amjmed.2003.06.004
Adams, Jared R., Linda S. Elting, Gary H. Lyman, James N. George, Barry C. Lembersky, James O. Armitage, George D. Demetri, and Charles L. Bennett. “Use of erythropoietin in cancer patients: assessment of oncologists' practice patterns in the United States and other countries.Am J Med 116, no. 1 (January 1, 2004): 28–34. https://doi.org/10.1016/j.amjmed.2003.06.004.
Adams JR, Elting LS, Lyman GH, George JN, Lembersky BC, Armitage JO, et al. Use of erythropoietin in cancer patients: assessment of oncologists' practice patterns in the United States and other countries. Am J Med. 2004 Jan 1;116(1):28–34.
Adams, Jared R., et al. “Use of erythropoietin in cancer patients: assessment of oncologists' practice patterns in the United States and other countries.Am J Med, vol. 116, no. 1, Jan. 2004, pp. 28–34. Pubmed, doi:10.1016/j.amjmed.2003.06.004.
Adams JR, Elting LS, Lyman GH, George JN, Lembersky BC, Armitage JO, Demetri GD, Bennett CL. Use of erythropoietin in cancer patients: assessment of oncologists' practice patterns in the United States and other countries. Am J Med. 2004 Jan 1;116(1):28–34.
Journal cover image

Published In

Am J Med

DOI

ISSN

0002-9343

Publication Date

January 1, 2004

Volume

116

Issue

1

Start / End Page

28 / 34

Location

United States

Related Subject Headings

  • United States
  • Topotecan
  • Regression Analysis
  • Practice Patterns, Physicians'
  • Practice Guidelines as Topic
  • Ovarian Neoplasms
  • Odds Ratio
  • Neoplasms
  • Medical Oncology
  • Managed Care Programs