Hemoglobin decline in chemotherapy patients prior to and after policy changes affecting use of erythropoiesis-stimulating agents: 2006-2009
| Autor: | Ze Cong, Gregory P. Hess, Jerrold Hill, N. McGarvey, Nordyke Rj |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Anemia medicine.medical_treatment Antineoplastic Agents Biochemistry Hemoglobins Internal medicine Neoplasms medicine Humans Aged Retrospective Studies Chemotherapy Myelosuppressive Chemotherapy business.industry United States Food and Drug Administration Biochemistry (medical) Cancer Cell Biology General Medicine Odds ratio Middle Aged medicine.disease Confidence interval United States Surgery Logistic Models Insurance Health Reimbursement Multivariate Analysis Practice Guidelines as Topic Hematinics Erythropoiesis Female Hemoglobin business |
| Zdroj: | The Journal of international medical research. 40(4) |
| ISSN: | 1473-2300 |
| Popis: | OBJECTIVE: Since 2007, the use of erythropoiesis-stimulating agents (ESAs) to treat anemia in cancer patients receiving chemotherapy has been increasingly restricted in the USA. This study assessed hemoglobin (Hb) decline over time among chemotherapy patients. METHODS: Episodes of chemotherapy care were identified in a large US-oncology electronic medical record database; weekly Hb levels were computed in the first 8 weeks. Unadjusted and adjusted proportions of patient-weeks with Hb decline > 1 g/dl (i.e. representing clinically significant decline) within 1 or 2 weeks were analyzed. RESULTS: Between 2006 and 2009, unadjusted proportions of patient-weeks with Hb decline > 1 g/dl increased (1-week, from 12.7% to 14.9%; 2-week, from 19.3% to 26.3%). Adjusted 1-week proportions in 2007 were similar to 2006, but increased in 2008 (odds ratio [OR] 1.135; 95% confidence intervals [CI] 1.067, 1.208) and in 2009 (OR 1.235; 95% CI 1.094, 1.395). Adjusted 2-week proportions had the same pattern. CONCLUSIONS: Since restrictions on ESA use were introduced in the USA, more patients have experienced a clinically significant Hb decline after chemotherapy initiation. Initiating anemia therapy at the earliest indicated opportunity may help reduce the risk of such declines. |
| Databáze: | OpenAIRE |
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