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. 2021 Nov;29(11):6831-6839.
doi: 10.1007/s00520-021-06277-8. Epub 2021 May 18.

A questionnaire survey on evaluation for penetration and compliance of the Japanese Guideline on Febrile Neutropenia among hematology-oncology physicians and surgeons

Nobu Akiyama  1 , Takuho Okamura  2 , Minoru Yoshida  3 , Shun-Ichi Kimura  4 , Shingo Yano  5 , Isao Yoshida  6 , Hiroyuki Kusaba  7 , Kosuke Takahashi  8 , Hiroyuki Fujita  9 , Keitaro Fukushima  10 , Hiromichi Iwasaki  11 , Kazuo Tamura  12 , Toshiaki Saeki  13 , Yasushi Takamatsu  14 , Sadamoto Zenda  15
Affiliations

A questionnaire survey on evaluation for penetration and compliance of the Japanese Guideline on Febrile Neutropenia among hematology-oncology physicians and surgeons

Nobu Akiyama et al. Support Care Cancer. 2021 Nov.

Abstract

Purpose: The Japanese Society of Medical Oncology published a guideline (GL) on febrile neutropenia (FN) in 2017. The study's purpose is to reveal how widely GL penetrated among physicians and surgeons providing chemotherapy.

Methods: A questionnaire survey was conducted with SurveyMonkey™ for members of the Japanese Association of Supportive Care in Cancer and relevant academic organizations. Each question had four options (always do, do in more than half of patients, do in less than half, do not at all) and a free description form. Responses were analyzed with statistical text-analytics.

Result: A total of 800 responses were retrieved. Major respondents were experts with more than 10-year experience, physicians 54%, and surgeons 46%. Eighty-seven percent of respondents knew and used GL. Forty-eight percent assessed FN with Multinational Association of Supportive Care in Cancer (MASCC) score "always" or "more than half." Eighty-one percent chose beta-lactam monotherapy as primary treatment in high-risk patients. Seventy-seven percent did oral antibacterial therapy in low-risk patients ambulatorily. Seventy-eight percent administered primary prophylactic G-CSF (ppG-CSF) in FN frequency ≥ 20% regimen. Fifty-nine percent did ppG-CSF for high-risk patients in FN frequency 10-20% regimen. Ninety-seven percent did not use ppG-CSF in FN frequency < 10% regimen. The medians of complete and complete plus partial compliance rates were 46.4% (range 7.0-92.8) and 77.8% (range 35.4-98.7). The complete compliance rates were less than 30% in seven recommendations, including the MASCC score assessment.

Conclusion: GL is estimated to be widely utilized, but some recommendations were not followed, presumably due to a mismatch with actual clinical practices in Japan.

Keywords: Chemotherapy; Febrile neutropenia; G-CSF; Guidelines; Supportive care; Surveillance.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Frequency distribution of choice in each question
See this image and copyright information in PMC

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