Dataset Information

Difference of compliance rates for the recommendations in Japanese Guideline on Febrile Neutropenia according to respondents' attributes: the second report on a questionnaire survey among hematology-oncology physicians and surgeons.

ABSTRACT:

Purpose

The Japanese Society of Medical Oncology (JSMO) published a guideline (GL) on febrile neutropenia (FN) in 2017. This study aims to identify promoting factors and disincentives for complying with GL recommendations according to attributes of doctors providing chemotherapy.

Methods

A questionnaire survey was conducted with SurveyMonkey™ for physician members of the Japanese Association of Supportive Care in Cancer and relevant academic organizations. Each question had four options (always do, do in more than half of patients, do in less than half, do not at all) and a free description form. Responses were analyzed according to the respondents' attributes.

Result

Seven hundred eighty-eight out of retrieved 801 responses were available for analysis. Multivariable analysis demonstrated that the percentage of GL users was higher among women and Japanese Society of Clinical Oncology members. The overall compliance rate was higher among women, JSMO members, and board-certified medical oncologists. Internists emphasized the significance of collecting blood cultures at FN onset, and surgeons stressed the importance of G-CSF prophylaxis. Hematologists were less likely to adhere to recommendations on risk assessment of FN by the Multinational Association of Supportive Care in Cancer score and administration of gammaglobulin products. However, those are acceptable due to the characteristics of their practice. Eight recommendations had no difference in compliance rates between users and non-users, some of whose statements were ambiguous and discretionary.

Conclusion

Women were more likely to use and adhere to GL. The recommendations should be developed considering the characteristics of specialty and subspecialty and avoiding ambiguity and discretionary statements.

SUBMITTER: Akiyama N

PROVIDER: S-EPMC8942955 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Difference of compliance rates for the recommendations in Japanese Guideline on Febrile Neutropenia according to respondents' attributes: the second report on a questionnaire survey among hematology-oncology physicians and surgeons.

Akiyama Nobu N Okamura Takuho T Yoshida Minoru M Kimura Shun-Ichi SI Yano Shingo S Yoshida Isao I Kusaba Hitoshi H Takahashi Kosuke K Fujita Hiroyuki H Fukushima Keitaro K Iwasaki Hiromichi H Tamura Kazuo K Saeki Toshiaki T Takamatsu Yasushi Y Zenda Sadamoto S

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 20220129 5

<h4>Purpose</h4>The Japanese Society of Medical Oncology (JSMO) published a guideline (GL) on febrile neutropenia (FN) in 2017. This study aims to identify promoting factors and disincentives for complying with GL recommendations according to attributes of doctors providing chemotherapy.<h4>Methods</h4>A questionnaire survey was conducted with SurveyMonkey™ for physician members of the Japanese Association of Supportive Care in Cancer and relevant academic organizations. Each question had four o ...[more]

PMID: 35094140

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Project description:BackgroundThe 2011 4th European Conference on Infections in Leukemia (ECIL4) guidelines recommend antibiotics de-escalation/discontinuation in selected febrile neutropenia (FN) patients. We aimed to assess the impact of an antimicrobial stewardship (AMS) program based on these guidelines on antibiotics use and clinical outcomes in high-risk FN patients.MethodsWe conducted an observational study in the hematology department of Cochin University Hospital in Paris, France. An ECIL4-based antibiotics de-escalation and discontinuation strategy was implemented jointly by the hematologists and the AMS team. The pre-intervention (January-October 2018) and post-intervention (January-October 2019) periods were compared. We retrospectively collected clinical and microbiological data. We compiled antibiotics consumptions via hospital pharmacy data and standardized them by calculating defined daily doses per 1000 patient-days. We analyzed the two-monthly antibiotic consumption using an interrupted time series method and built a composite endpoint for clinical outcomes based on transfer to the intensive care unit (ICU) and/or hospital death.ResultsOverall, 273 hospital stays (164 patients) in the pre-intervention and 217 (148 patients) in the post-intervention periods were analyzed. Patients were mainly hospitalized for intensive chemotherapy for acute leukemia or autologous stem-cell transplant for myeloma. Patients were slightly younger in the pre-intervention compared to the post-intervention period (median age 60.4 vs 65.2 years, p = 0.049), but otherwise comparable. After implementation of the AMS program, glycopeptide and carbapenem use decreased by 85% (p = 0.03) and 72% (p = 0.04), respectively. After adjustment on confounders, the risk of transfer to the ICU/death decreased significantly after implementation of the AMS program (post-intervention period: odds-ratio = 0.29, 95% Confidence Interval: 0.15-0.53, p < 0.001).ConclusionImplementation of a multidisciplinary AMS program for high-risk neutropenic patients was associated with lower carbapenem and glycopeptide use and improved clinical outcomes.

Project description:ObjectivesThis study aimed to investigate the knowledge, attitude and practice (KAP) towards chemotherapy-related neutropenia and febrile neutropenia (FN) among breast cancer patients. The major hypothesis was that demographic characteristics influence patients' KAP regarding chemotherapy-related neutropenia and FN.DesignA multi-centre cross-sectional study.SettingConducted in four secondary care hospitals between April and June 2023.ParticipantsThe study enrolled 246 breast cancer patients undergoing chemotherapy. Participants were aged 18 years or older, currently on chemotherapy and willing to complete the questionnaire. Exclusion criteria included significant cognitive impairments.Primary and secondary outcome measuresPrimary outcome measures were KAP scores regarding chemotherapy-related neutropenia and FN. Secondary outcomes included factors associated with adequate knowledge and positive attitudes.ResultsA total of 246 patients completed the questionnaire. The mean knowledge score was 12.46±6.21 (range: 0-26), and the mean attitude score was 30.00±2.58 (range: 7-35). Less than half of the patients (45.95%) knew whether their chemotherapy protocol was high risk for FN, while 79.67% were aware of the need for prophylactic administration of leukocyte-raising agents. Multivariate logistic regression analysis revealed that having a junior college education or higher was significantly associated with knowledge scores (OR=4.69, 95% CI 2.23 to 9.89, p<0.001). Living in urban areas was associated with attitude scores (OR=0.58, 95% CI 0.34 to 0.97, p=0.037). Structural equation modelling analysis indicated that experience with chemotherapy-related neutropenia or FN influenced knowledge to some degree (β=1.77, p=0.029).ConclusionsThe study found inadequate knowledge, a positive attitude and suboptimal practice towards chemotherapy-related neutropenia and FN among breast cancer patients undergoing chemotherapy. Tailored education programmes are needed to improve KAP in this patient population. Further research should explore additional demographic and psychosocial factors influencing KAP to develop comprehensive educational interventions.

Dataset Information

Difference of compliance rates for the recommendations in Japanese Guideline on Febrile Neutropenia according to respondents' attributes: the second report on a questionnaire survey among hematology-oncology physicians and surgeons.

Purpose

Methods

Result

Conclusion

Publications

Difference of compliance rates for the recommendations in Japanese Guideline on Febrile Neutropenia according to respondents' attributes: the second report on a questionnaire survey among hematology-oncology physicians and surgeons.

Similar Datasets

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