目的:初级预防性粒细胞集落刺激因子(PP-CSF)与化疗方案一起使用,这些化疗方案具有高热性中性粒细胞减少症(FN)的风险。作为S1415CD的一部分,一个潜在的,务实试验评估自动订单对改善PP-CSF处方的影响,我们评估了患者对PP-CSF的基线知识,以及该知识在第一周期化疗后是否有所改善.
方法:成年乳腺癌患者,结直肠,2016年1月至2020年4月,S1415CD纳入了非小细胞肺癌起始化疗方案.八个问题评估脑脊液适应症的知识,风险,好处,和自付费用被纳入基线调查和第一个化疗周期结束时的随访调查.反应由试验组分层,化疗是否低,中间,或高FN风险。
结果:在3605名符合条件的患者中,3580人(99.3%)完成基线调查,和3420(95.5%)完成了后续调查。在基线,803名(22.4%)患者对所有8个问题回答“不知道”,和所有患者平均2.75正确的问题。在后续行动中,高FN风险组的知识增加了0.34(p<0.001),但其他FN风险组的知识下降。在多变量分析中,接受高FN风险方案和年龄较小与知识改善显著相关.
结论:化疗患者对PP-CSF的认识不足,在接受高FN风险化疗的患者中,PP-CSF的改善幅度不大。进一步努力告知患者风险,好处,PP-CSF的成本可能是有保证的,特别是对于那些需要预防的人。
背景:NCT02728596,2016年4月6日。
OBJECTIVE: Primary prophylactic granulocyte colony-stimulating factors (PP-CSFs) are prescribed alongside chemotherapy regimens that carry a significant risk of febrile neutropenia (FN). As part of S1415CD, a prospective, pragmatic trial evaluating the impact of automated orders to improve PP-CSF prescribing, we evaluated patients\' baseline knowledge of PP-CSF and whether that knowledge improved following the first cycle of chemotherapy.
METHODS: Adult patients with breast, colorectal, or non-small-cell lung cancer initiating chemotherapy were enrolled in S1415CD between January 2016 and April 2020. Eight questions assessing knowledge of CSF indications, risks, benefits, and out-of-pocket costs were included in a baseline survey and in a follow-up survey at the end of the first cycle of chemotherapy. Responses were stratified by the trial arm and whether chemotherapy was low, intermediate, or high FN risk.
RESULTS: Of the 3605 eligible patients, 3580 (99.3%) completed the baseline survey, and 3420 (95.5%) completed the follow-up survey. At baseline, 803 (22.4%) patients responded \"Don\'t know\" to all 8 questions, and all patients averaged 2.75 correct questions. At follow-up, knowledge increased by 0.34 in the high-FN-risk group (p < 0.001) but declined for the other FN-risk groups. In multivariate analysis, receiving a high-FN-risk regimen and younger age were significantly associated with knowledge improvement.
CONCLUSIONS: Chemotherapy patients had poor knowledge of PP-CSF that improved only modestly among recipients of high-FN-risk chemotherapy. Further efforts to inform patients about the risks, benefits, and costs of PP-CSF may be warranted, particularly for those in whom prophylaxis is indicated.
BACKGROUND: NCT02728596, April 6, 2016.