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Quality management of potential chemotherapy-induced neutropenic complications: evaluation of practice in an academic medical center.

Publication ,  Journal Article
Abernethy, AP; Barbour, SY; Uronis, H; Zafar, SY; Coan, A; Rowe, K; Pupa, MR; Wheeler, JL; Herndon, JE
Published in: Support Care Cancer
June 2009

GOALS: Management of the risk of potential chemotherapy-induced neutropenic complications such as febrile neutropenia (FN) and severe neutropenia (SN) is a quality of care priority. How frequently does care at our institution conform to established guidelines? MATERIALS AND METHODS: This retrospective chart review study included a random sample of 305 cancer patients receiving care at a single US academic medical center. Abstracted data included demographics, risk factors, and outcome variables (e.g., development of FN/SN, administration of myeloid growth factors). To evaluate quality of care, we assessed conformance between actual practice and established clinical practice guidelines for the use of myeloid growth factors from the National Comprehensive Cancer Network (NCCN). MAIN RESULTS: Of the 305 cases reviewed, 8% were classified as low risk (<10%), 48% as intermediate risk (10-20%), and 44% as high risk (>20%), using the risk classifications in the NCCN guidelines modified to accommodate illness and other risk factors. Thirty-four percent received prophylactic administration of myeloid growth factors. Half of the cases had adequate documentation of mid-cycle absolute neutrophil count to determine whether FN/SN developed. Among these cases with adequate documentation, 21% developed FN/SN. Use of growth factors did not conform to established quality guidelines. Overall, 77 of 133 (58%) high-risk cases received myeloid growth factors, whereas six of 25 (24%) low-risk cases received myeloid growth factors. CONCLUSIONS: Routine clinical practice in this academic oncology setting was poorly aligned with established guidelines; there is substantial opportunity to standardize clinical strategies and increase conformance with evidence-based guidelines.

Duke Scholars

Published In

Support Care Cancer

DOI

EISSN

1433-7339

Publication Date

June 2009

Volume

17

Issue

6

Start / End Page

735 / 744

Location

Germany

Related Subject Headings

  • Young Adult
  • United States
  • Risk Factors
  • Retrospective Studies
  • Quality of Health Care
  • Practice Guidelines as Topic
  • Oncology & Carcinogenesis
  • Neutropenia
  • Neoplasms
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Abernethy, A. P., Barbour, S. Y., Uronis, H., Zafar, S. Y., Coan, A., Rowe, K., … Herndon, J. E. (2009). Quality management of potential chemotherapy-induced neutropenic complications: evaluation of practice in an academic medical center. Support Care Cancer, 17(6), 735–744. https://doi.org/10.1007/s00520-008-0562-6
Abernethy, Amy P., Sally Y. Barbour, Hope Uronis, S Yousuf Zafar, April Coan, Krista Rowe, Mary Ruth Pupa, Jane L. Wheeler, and James E. Herndon. “Quality management of potential chemotherapy-induced neutropenic complications: evaluation of practice in an academic medical center.Support Care Cancer 17, no. 6 (June 2009): 735–44. https://doi.org/10.1007/s00520-008-0562-6.
Abernethy AP, Barbour SY, Uronis H, Zafar SY, Coan A, Rowe K, et al. Quality management of potential chemotherapy-induced neutropenic complications: evaluation of practice in an academic medical center. Support Care Cancer. 2009 Jun;17(6):735–44.
Abernethy, Amy P., et al. “Quality management of potential chemotherapy-induced neutropenic complications: evaluation of practice in an academic medical center.Support Care Cancer, vol. 17, no. 6, June 2009, pp. 735–44. Pubmed, doi:10.1007/s00520-008-0562-6.
Abernethy AP, Barbour SY, Uronis H, Zafar SY, Coan A, Rowe K, Pupa MR, Wheeler JL, Herndon JE. Quality management of potential chemotherapy-induced neutropenic complications: evaluation of practice in an academic medical center. Support Care Cancer. 2009 Jun;17(6):735–744.
Journal cover image

Published In

Support Care Cancer

DOI

EISSN

1433-7339

Publication Date

June 2009

Volume

17

Issue

6

Start / End Page

735 / 744

Location

Germany

Related Subject Headings

  • Young Adult
  • United States
  • Risk Factors
  • Retrospective Studies
  • Quality of Health Care
  • Practice Guidelines as Topic
  • Oncology & Carcinogenesis
  • Neutropenia
  • Neoplasms
  • Middle Aged