Healthcare utilisation in patients with breast cancer or non-Hodgkin lymphoma who experienced febrile neutropenia in the Netherlands: a retrospective matched control study using the PHARMO database

Abstract

Few data have been published on healthcare resource utilisation associated with chemotherapy-induced febrile neutropenia (FN) in Europe. Using the PHARMO record linkage system, we identified incident adult patients with a primary hospital discharge diagnosis of breast cancer (BC) or non-Hodgkin lymphoma (NHL) from 1998 to 2008. Patients who experienced FN were matched 1:2 non-FN reference patients. Of 1033 BC patients, 80 (8%) had FN and were matched with 160 reference patients; and of 486 NHL patients, 95 (20%) had FN and 89 were matched with 178 reference patients. Significantly more FN patients were hospitalised for any cause than reference patients: BC, 81% vs. 24% (OR 12.6; 95% CI 5.7-27.8); NHL, 82% vs. 44% (OR 6.7; 95% CI 3.3-13.9). Median length of all-cause hospitalisation stay was higher for FN patients: BC, 4.0 vs. 1.0 days; NHL, 8.5 vs. 1.8 days. The median (interquartile range) number of medication treatments was higher for FN patients: BC, 5.5 (4.0-7.5) vs. 2.0 (2.0-4.0); NHL, 8.0 (5.0-11.0) vs. 3.0 (2.0-4.0). In conclusion, FN in patients with BC or NHL had increased healthcare utilisation compared with non-FN patients; thus, efforts to reduce FN are warranted to reduce cost and improve outcomes.

Management of Breast Cancer Patients with Chemotherapy-Induced Neutropenia or Febrile Neutropenia

“…A recent case-control study showed that FN is associated with higher health care resource use in BC patients compared to non-FN patients [45]. BC patients with a history of FN had an increased risk of all-cause hospitalization in the first month after the febrile event compared with patients who never experienced FN (odds ratio (OR) = 23.0, 95% confidence interval (CI) 8.3-63.7) and they also had a longer median length of stay of all-cause hospitalizations (4 days vs. 1 day).…”

Exploring the burden of short-term CHOP chemotherapy adverse events in post-transplant lymphoproliferative disease: a comprehensive literature review in lymphoma patients

“…Studies recruiting an EU population accounted for the greatest proportion of research (41%) ( Figure 2D). (16 studies [24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39])…”

“…A patient's first FN episode was most likely to occur during the first cycle of chemotherapy [25,27,35]. In both the US and EU/Canada, FN events were predominantly treated in the inpatient setting [31,39]. In the US, up to 84% of patients require at least one hospitalization [30] and many require multiple hospitalizations [25].…”

“…In the US, up to 84% of patients require at least one hospitalization [30] and many require multiple hospitalizations [25]. Mean hospital length of stay (LOS) for patients with FN varied (range: 7.9 to 9.8 days in the US [25,32,37] and 6 to A c c e p t e d M a n u s c r i p t 11.8 in EU/Canada [27,29,31,35,39]). Mean LOS was longer in FN patients with multiple hospitalizations [25], older patients [25], and patients with comorbidities [31] (Table 2).…”

“…Mean hospital length of stay (LOS) for patients with FN varied (range: 7.9 to 9.8 days in the US [25,32,37] and 6 to A c c e p t e d M a n u s c r i p t 11.8 in EU/Canada [27,29,31,35,39]). Mean LOS was longer in FN patients with multiple hospitalizations [25], older patients [25], and patients with comorbidities [31] (Table 2). Patients with FN also required additional office visits and other procedures [31,32,39].…”