Managing cancer-related anaemia in congruence with the EORTC guidelines is an independent predictor of haemoglobin outcome: Initial evidence from the RESPOND study

Received 22 June 2008; received in revised form 5 September 2008; accepted 30 September 2008. published online 08 December 2008.

Abstract

Purpose

To model the relationship between scores for practicing in congruence (CSs; 0–10) with EORTC guidelines for erythropoietic proteins (EPs) and haemoglobin (Hb) outcomes observed in the validation study of the RESPOND system.

Methods

Thirty four patient pairs matched on cancer type and chemotherapy in pre- (retrospective; clinicians not using RESPOND) and post-cohorts (prospective; clinicians using RESPOND) followed over 4 months following EP treatment initiation. CSs quantify the extent that care was guideline-adherent. Linear and logistic regressions controlling for cohort examined Hb outcomes as a function of CSs.

Results

A one-point increase in CS was associated with 0.60g/dL increase in Hb at month 4 (R2=0.40) and 0.56g/dL increase in Hb change from month 1–4 (R2=0.33). Each one-point increase in CS increased the odds of reaching Hb⩾11g/dL by 3.14 (R2=0.42) and Hb⩾12g/dL by 2.77 (R2=0.45).

Conclusion

Guideline-adherent EP treatment may improve Hb outcomes but specifically designed outcomes studies are necessary.

Keywords: Anaemia, Evidence-based practice guidelines, Erythropoietin

a Institut Multidisciplinaire d’Oncologie, Clinique de Genolier, 1 Route du Muids, CH-1272 Genolier, Switzerland

b Afdeling Oncologie en Hematologie, Algemeen Stedelijk Ziekenhuis Aalst, Merestraat 80, B-9300 Aalst, Belgium

c Matrix45, 620 Frays Ridge Road, Earlysville, VA 22936, USA

d Institut Bergonié, 229 cours de l’Argonne, F-33076 Bordeaux, France

e Université Victor Segalen Bordeaux 2, 146 rue Léo Saignat, F-33076 Bordeaux, France

f F. Hoffmann-La Roche AG, Grenzacherstrasse, Bau 74, CH-4070 Basel, Switzerland

g Roche, Dantestraat 75, B-1070 Brussel, Belgium

h School of Nursing, University of Virginia, 202 15th Street SW, Charlottesville, VA 22903, USA

i College of Nursing and Center for Health Outcomes and Pharmacoeconomic Research, Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, 1305 N. Martin Road, Tucson, AZ 85721, USA

Corresponding author: Address: Matrix45, 620 Frays Ridge Road, Earlysville, VA 22936, USA. Tel.: +1 303 997 2697; fax: +1 978 945 8374.

PII: S0959-8049(08)00784-3

doi:10.1016/j.ejca.2008.09.036

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