Drug Utilization Evaluation of filgrastim and pegfilgrastim (DUE) in outpatient prescription refer to drug information and shahid Tofighi pharmacies for three months in 2019

Abstract

Fever and neutropenia are of the most common problems in patients with malignancies which can interfere with standard treatment and increase mortality. Based on current guidelines, Granulocyte Colony Stimulating Factors (G-CSF) are routine prophylaxis for neutropenic fever. Considering the cost of hospitalization due to an episode of neutropenic fever, prevention is preferred over treatment. Aim of study:The aim of this study was to evaluate the prescription patterns of filgrastim and pegfilgrastim (routine prophylactic choice for neutropenic fever) in malignancy patients.Methods and materials:All patients who were aware of their malignancy and subsequently admitted to one of the pharmacies affiliated to Tabriz University of Medical Sciences to get their prescription filled, were eligible to participate. After, acquiring written consent, demographic data as well as patients clinical and medication history were recorded. Then, data was evaluated by statistical methods. Results:Adherence to guidelines was statistically associated with G-CSF type. Pegfilgrastim prescription was adherent in 40.7% of cases versus filgrastim with 30.5%. All patients who had been planed to recieve high risk chemotherapy regimens, were prescribed with guidline adherent prophylaxis. Despite the fact that low risk patients had a 0% adherence rate with guidelines. Conclusion:Our study showed that the adherence of filgrastim and pegfilgrastim use with guidelines was not optimal. Adherence rate was affected by patient’s sex, G-CSF type and the risk of neutropenia onset. Although, our results may not be generalized to other provinces. Therefore, we encourage similar DUE studies with large scale data collection. We also emphasize potential role of Clinical pharmacists in reaching optimum drug utilization.