Granulocyte colony stimulating factor use and adherence to clinical practice guidelines among women with breast cancer living in Puerto Rico: a population-based study
Abstract Background Febrile Neutropenia (FN) is a common and serious condition related to cancer chemotherapy. Human recombinant Granulocyte-Colony Stimulating Factor (G-CSF) prevents and attenuates the severity and duration of FN. We evaluated the use and predictors of G-CSF adherence among women w...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-022-08325-3 |
| _version_ | 1817969670712459264 |
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| author | Yarixabeth Jiménez Nieves Karen J. Ortiz-Ortiz Ruth E. Ríos Motta Maira A. Castañeda-Avila Guillermo Tortolero-Luna |
| author_facet | Yarixabeth Jiménez Nieves Karen J. Ortiz-Ortiz Ruth E. Ríos Motta Maira A. Castañeda-Avila Guillermo Tortolero-Luna |
| author_sort | Yarixabeth Jiménez Nieves |
| collection | DOAJ |
| description | Abstract Background Febrile Neutropenia (FN) is a common and serious condition related to cancer chemotherapy. Human recombinant Granulocyte-Colony Stimulating Factor (G-CSF) prevents and attenuates the severity and duration of FN. We evaluated the use and predictors of G-CSF adherence among women with breast cancer with a high risk of FN in Puerto Rico. Methods This retrospective cohort study used the Puerto Rico Central Cancer Registry-Health Insurance Linkage Database. Women with invasive breast cancer diagnosed during 2009-2015 who received selected chemotherapy regimens (n = 816) were included. The risk of FN was categorized as high and low risk based on the chemotherapy regimens according to the National Comprehensive Cancer Network guidelines and literature. Adherence was defined as the use or no use of G-CSF at the start of the first chemotherapy cycle among women with breast cancer based on the risk of developing FN. We used a multivariate logistic model to identify factors associated with G-CSF use in women classified at high risk for FN. Results Adherence to G-CSF clinical practice guidelines was low (38.2%) among women with a high risk of FN. Women at high risk of FN with Medicaid (aOR: 0.14; CI 95%: 0.08, 0.24) and Medicare/Medicaid (aOR: 0.33; CI 95%: 0.15, 0.73) were less likely to receive G-CSF than women with private health insurance. Women with regional stage (aOR: 1.82; CI 95%: 1.15, 2.88) were more likely to receive G-CSF than women with localized cancers. Conclusions Adherence to clinical practice guidelines was poor among women with a high risk of FN. Furthermore, disparities in the adherence to G-CSF use in terms of health insurance, health region, and cancer stage granted the opportunity to implement strategies to follow the recommended guidelines for using G-CSF as part of cancer treatment. |
| first_indexed | 2024-04-13T20:24:05Z |
| format | Article |
| id | doaj.art-b694fd22aa16486a9d0503700fafc935 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-13T20:24:05Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-b694fd22aa16486a9d0503700fafc9352022-12-22T02:31:26ZengBMCBMC Health Services Research1472-69632022-07-012211810.1186/s12913-022-08325-3Granulocyte colony stimulating factor use and adherence to clinical practice guidelines among women with breast cancer living in Puerto Rico: a population-based studyYarixabeth Jiménez Nieves0Karen J. Ortiz-Ortiz1Ruth E. Ríos Motta2Maira A. Castañeda-Avila3Guillermo Tortolero-Luna4Department of Health Services Administration, Graduate School of Public Health, Medical Sciences Campus, University of Puerto RicoDepartment of Health Services Administration, Graduate School of Public Health, Medical Sciences Campus, University of Puerto RicoDepartment of Health Services Administration, Graduate School of Public Health, Medical Sciences Campus, University of Puerto RicoDepartment of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical SchoolDivision of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer CenterAbstract Background Febrile Neutropenia (FN) is a common and serious condition related to cancer chemotherapy. Human recombinant Granulocyte-Colony Stimulating Factor (G-CSF) prevents and attenuates the severity and duration of FN. We evaluated the use and predictors of G-CSF adherence among women with breast cancer with a high risk of FN in Puerto Rico. Methods This retrospective cohort study used the Puerto Rico Central Cancer Registry-Health Insurance Linkage Database. Women with invasive breast cancer diagnosed during 2009-2015 who received selected chemotherapy regimens (n = 816) were included. The risk of FN was categorized as high and low risk based on the chemotherapy regimens according to the National Comprehensive Cancer Network guidelines and literature. Adherence was defined as the use or no use of G-CSF at the start of the first chemotherapy cycle among women with breast cancer based on the risk of developing FN. We used a multivariate logistic model to identify factors associated with G-CSF use in women classified at high risk for FN. Results Adherence to G-CSF clinical practice guidelines was low (38.2%) among women with a high risk of FN. Women at high risk of FN with Medicaid (aOR: 0.14; CI 95%: 0.08, 0.24) and Medicare/Medicaid (aOR: 0.33; CI 95%: 0.15, 0.73) were less likely to receive G-CSF than women with private health insurance. Women with regional stage (aOR: 1.82; CI 95%: 1.15, 2.88) were more likely to receive G-CSF than women with localized cancers. Conclusions Adherence to clinical practice guidelines was poor among women with a high risk of FN. Furthermore, disparities in the adherence to G-CSF use in terms of health insurance, health region, and cancer stage granted the opportunity to implement strategies to follow the recommended guidelines for using G-CSF as part of cancer treatment.https://doi.org/10.1186/s12913-022-08325-3Febrile neutropeniaGranulocyte colony stimulating factorBreast cancerHealth insuranceClinical practice guidelines |
| spellingShingle | Yarixabeth Jiménez Nieves Karen J. Ortiz-Ortiz Ruth E. Ríos Motta Maira A. Castañeda-Avila Guillermo Tortolero-Luna Granulocyte colony stimulating factor use and adherence to clinical practice guidelines among women with breast cancer living in Puerto Rico: a population-based study BMC Health Services Research Febrile neutropenia Granulocyte colony stimulating factor Breast cancer Health insurance Clinical practice guidelines |
| title | Granulocyte colony stimulating factor use and adherence to clinical practice guidelines among women with breast cancer living in Puerto Rico: a population-based study |
| title_full | Granulocyte colony stimulating factor use and adherence to clinical practice guidelines among women with breast cancer living in Puerto Rico: a population-based study |
| title_fullStr | Granulocyte colony stimulating factor use and adherence to clinical practice guidelines among women with breast cancer living in Puerto Rico: a population-based study |
| title_full_unstemmed | Granulocyte colony stimulating factor use and adherence to clinical practice guidelines among women with breast cancer living in Puerto Rico: a population-based study |
| title_short | Granulocyte colony stimulating factor use and adherence to clinical practice guidelines among women with breast cancer living in Puerto Rico: a population-based study |
| title_sort | granulocyte colony stimulating factor use and adherence to clinical practice guidelines among women with breast cancer living in puerto rico a population based study |
| topic | Febrile neutropenia Granulocyte colony stimulating factor Breast cancer Health insurance Clinical practice guidelines |
| url | https://doi.org/10.1186/s12913-022-08325-3 |
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