OBJECTIVE: To describe the incidence of febrile neutropenia (FN) and use of pegfilgrastim in cancer patients with high overall risk of FN and to investigate the relationship between granulocyte-colony stimulating factor (G-CSF) guideline adherence and chemotherapy delivery in Central and Eastern Europe (CEE) and Austria. METHODS: Dose Intensity Evaluation Program and Prophylaxis (DIEPP) was a multicentre, prospective, and observational study of adult patients with breast cancer, lymphoma, lung cancer, gastric cancer, and ovarian cancer, who received chemotherapy with pegfilgrastim support and who had an overall risk of FN ≥ 20 %. Physicians assessed patient risk factors and reported their reasons for administering pegfilgrastim. RESULTS: Patients were enrolled from 113 centres in CEE and Austria between August 2010 and July 2013, and data were analysed from 1072 patients. The most common tumour types were breast cancer (50 %) and lymphoma (24 %). FN incidence was 5 % overall. FN occurred in 3 % of patients (28/875) who received pegfilgrastim as primary prophylaxis (PP) and 13 % of patients (19/142) who received it as secondary prophylaxis (SP); 79 % of FN events in SP patients occurred in the first cycle before pegfilgrastim was administered. The three most frequently chosen reasons for using pegfilgrastim were planned chemotherapy with high FN risk, female gender, and advanced disease. Overall, 40 % of patients received > 90 % of their planned chemotherapy dose within 3 days of the planned schedule. CONCLUSION: FN incidence was relatively low with pegfilgrastim PP in patients with a physician-assessed overall FN risk of ≥ 20 %. The most important reasons for pegfilgrastim use were consistent with the investigators' risk assessment and international guidelines.
- MeSH
- dodržování směrnic využití MeSH
- dospělí MeSH
- faktor stimulující kolonie granulocytů aplikace a dávkování normy MeSH
- febrilní neutropenie vyvolaná chemoterapií epidemiologie prevence a kontrola MeSH
- incidence MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory farmakoterapie epidemiologie MeSH
- neutropenie epidemiologie prevence a kontrola MeSH
- rekombinantní proteiny aplikace a dávkování normy MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- výsledek terapie MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- Geografické názvy
- Rakousko epidemiologie MeSH
- východní Evropa epidemiologie MeSH
OBJECTIVE: This paper analyzes evidence of the impact of patients' adherence to pharmacological and non-pharmacological recommendations on the treatment costs of heart failure (HF) patients. METHODS: A systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Papers were searched using various combinations of the following keywords: 'telemedicine', 'telemonitoring', 'telehealth', 'eHealth', 'remote monitoring', 'adherence', 'compliance', 'cost-effectiveness', 'cost-benefit', 'heart failure', 'healthcare costs', 'hospitalization', and 'drug costs'. We included only papers written in English or German, published between 1998 and 2014, and having one of our search terms in the title. RESULTS: Initially, 73 papers were selected. After a detailed review, these were narrowed done to 9 that reported an association between adherence and/or compliance and costs. However, none established a quantitative relationship between adherence and total healthcare costs. CONCLUSION: A model-based cost-effectiveness analysis that appropriately considers adherence has not been carried out so far, but is needed to fully understand the potential economic benefits of telehealth.
- MeSH
- dodržování směrnic ekonomika využití MeSH
- kardiologie ekonomika normy MeSH
- lidé MeSH
- náklady na zdravotní péči statistika a číselné údaje MeSH
- prevalence MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- srdeční selhání diagnóza ekonomika terapie MeSH
- telemedicína ekonomika normy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- MeSH
- chybná zdravotní péče MeSH
- dodržování směrnic normy využití MeSH
- komunikace MeSH
- kontinuální vzdělávání zdravotních sester MeSH
- kvalita zdravotní péče využití MeSH
- lidé MeSH
- nesouhlas a spor MeSH
- ošetřovatelská péče metody trendy MeSH
- pracoviště psychologie MeSH
- zdravotní sestry MeSH
- Check Tag
- lidé MeSH
