Division of Pharmacy, Unit 90, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
Support Care Cancer. 2010 Feb;19(2):251-9. doi: 10.1007/s00520-009-0811-3. Epub 2010 Jan 26.
The objective of this study was to assess the impact of a new evidence-based institutional practice algorithm on the patterns and costs of treatment of chemotherapy-induced anemia (CIA) in lymphoma patients prescribed erythropoietic-stimulating agents (ESAs).
The study design was retrospective, with a historical control group. Patient demographic data, clinical data (including chemotherapy and hemoglobin values), and cost data were extracted from patient medical charts and institutional databases. Descriptive statistics, t tests, and chi-square analyses were conducted to evaluate the study objectives.
The study population consisted of 154 patients, 90 patients in the pre-implementation group and 64 in the post-implementation group. Both groups had similar demographic and baseline clinical characteristics. After implementation, there was a significant decrease in the mean hemoglobin level at the time of subsequent ESA dosing from 9.59 to 8.98 g/dL (P < 0.0001). The proportion of patients who received an ESA at a hemoglobin level >10 g/dL decreased significantly from 66% to 17% (P < 0.0001). There was no significant difference in the mean hemoglobin level at week 4 of ESA therapy, which may indicate that patients were not clinically affected by the change in practice. There were also no significant differences in the number of transfusions administered associated with the treatment of CIA in the study population.
The results of the study show an association between implementation of the new institutional practice algorithm for ESA usage in CIA and a change in ESA utilization patterns.
本研究旨在评估新的基于证据的机构实践算法对接受促红细胞生成刺激剂（ESA）治疗的淋巴瘤患者化疗引起的贫血（CIA）治疗模式和成本的影响。
研究设计为回顾性，有历史对照组。从患者病历和机构数据库中提取患者人口统计学数据、临床数据（包括化疗和血红蛋白值）和成本数据。采用描述性统计、t 检验和卡方分析评估研究目标。
研究人群包括 154 例患者，实施前组 90 例，实施后组 64 例。两组的人口统计学和基线临床特征相似。实施后，随后 ESA 给药时的平均血红蛋白水平从 9.59 降至 8.98 g/dL（P < 0.0001），差异有统计学意义。血红蛋白水平>10 g/dL 时接受 ESA 的患者比例从 66%显著降至 17%（P < 0.0001）。ESA 治疗第 4 周的平均血红蛋白水平无显著差异，这可能表明患者的临床状况未因实践改变而受到影响。研究人群中 CIA 治疗相关的输血数量也无显著差异。
研究结果表明，在 CIA 中使用 ESA 的新机构实践算法的实施与 ESA 使用模式的改变之间存在关联。
