Filgrastim use in the emergency department of a Spanish general hospital

Int J Clin Pharmacol Ther. 2014 Jun;52(6):492-6. doi: 10.5414/CP202029.

Abstract

Background: Febrile neutropenia is a cause of dose reduction in hematological cancer treatments, with patient risk of infection proportional to duration and severity. In addition, colony-stimulating factors have been shown to be beneficial in a patient subgroup, although they are probably overused in the clinical setting.

Objective: Evaluation of compliance with American Society of Clinical Oncology 2006 criteria when it comes to filgrastim use in the Emergency Department of a Spanish general hospital.

Methods and materials: A prospective observational study from August 2011 to February 2012 in a tertiary Spanish General Hospital. We included all patients prescribed with filgrastim in the Emergency Department. Data was collected on demographics, the pharmacotherapy history, the administered chemoprophylaxis, and the destination after discharge from a clinical department, the complete blood count, and the presence of fever >= 38 °C.

Results: 51 patients were recorded over the period of the study. 27.45% of prescriptions complied with the clinical practice guideline criteria given the risk of febrile neutropenia, whereas 72.34% of prescriptions did not comply with the criteria, 17.65% of which did not fulfil any requirements.

Conclusions: A high percentage of colony-stimulating factors use in the Emergency Department does not comply with the medical practice guideline.

Publication types

  • Observational Study

MeSH terms

  • Drug Utilization Review
  • Emergency Service, Hospital* / standards
  • Febrile Neutropenia / blood
  • Febrile Neutropenia / diagnosis
  • Febrile Neutropenia / drug therapy*
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Guideline Adherence
  • Hospitals, General* / standards
  • Hospitals, University* / standards
  • Humans
  • Immunologic Factors / therapeutic use*
  • Inappropriate Prescribing
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'* / standards
  • Prospective Studies
  • Recombinant Proteins / therapeutic use
  • Spain

Substances

  • Immunologic Factors
  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Filgrastim