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

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.

Difference of compliance rates for the recommendations in Japanese Guideline on Febrile Neutropenia according to respondents’ attributes: the second report on a questionnaire survey among hematology-oncology physicians and surgeons

“…In the previous report, we demonstrated and discussed the results of question-based analysis [1]. This report discusses the results based on the respondent's attribute and explores clues to interventions corresponding to the characteristics of each attribute.…”

“…The questionnaire consisting of twenty-one questions on GL and seven on attributes of respondents was surveyed from March to May 2020 through SurveyMonkey™ for the members of the Japanese Association of Supportive Care in Cancer (JSCC), JSMO, the Japanese Society of Hematology (JSH), and the Japanese Breast Association (JBA) (Table 1). The precise methods of surveillance were reported previously [1]. Each question had four options, (1) always do, (2) do in more than half of patients, (3) do in less than half of patients, and (4) do not at all, and a free description form, except for Q1.…”

“…SRG was also divided into breast surgeons (BRS) and surgeons other than breast surgery (NBS), including gastroenteric surgeons, thoracic surgeons, gynecologists, urologists. The details of respondents' specialties were mentioned in the previous report [1]. The analyses included two societies and two certifications related to cancer chemotherapy that may influence the use and compliance.…”

“…The C + PCR of Q16 in HEM vs. ONC was 68.2% vs. 48.3% (P < 0.001). The disincentive for Q16 in ONC is considered to reflect the economic issues indicated in the free comments reported previously [1].…”

“…We previously published the first report of a questionnaire survey on penetration and application of the Japanese Guidelines (GL) on febrile neutropenia (FN), and revised the second edition published by the Japanese Society of Medical Oncology (JSMO) [1]. It demonstrated that 86.7% of respondents knew and used GL; the medians of the complete and complete plus partial compliance rates, which denote the response of "always do" and "always do" plus "do in more than half of patients" in the questionnaire, were 46.4% (range: 7.0-92.8) and 77.8% (range: 35.4-98.7), respectively, in twenty recommendations.…”