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Onmark report pinpoints ways of reducing neutropenic complications for cancer patients
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McKesson UK
: 28 May, 2009 (Application Story) |
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Onmark releases findings from the company’s 2008 Integrated Quality (IQ) Program on Febrile Neutropenia Management. |
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Survey results revealed that 65 percent of eligible non-Hodgkin’s Lymphoma (NHL) and 80 percent of breast cancer patients who were on chemotherapy regimens associated with a high risk of febrile neutropenia received white blood cell growth factors (WBC-GF). Further analysis revealed that in patients age 65 and over, a group who is at higher risk of neutropenic complications, approximately 30 percent did not receive WBC-GF. For clinicians who chose not to use growth factor, the most common reason across both diagnoses was physician preference to “watch and wait”. Relatively few participants indicated that their decision-making involved recommendations contained in practice-level or national guidelines.
“These findings illustrate the importance of educating clinicians about guidelines and assessing practice patterns to identify potential areas of quality improvement,” noted Kim Bergstrom, chief clinical officer for McKesson Specialty Care Solutions. “Following guidelines is an effective way to decrease variability in practice and improve quality of care. National guidelines recommend assessing the risk of neutropenic complications, taking into consideration the chemotherapy regimen and individual risk factors. These guidelines also suggest that the use of WBC-GF is appropriate to consider in patients over age 65 who are receiving regimens associated with a moderate to high risk of neutropenic complications, including hospitalisation or prolonged treatment.
The 2008 Febrile Neutropenia Management IQ Program was designed to obtain information regarding proper utilization of WBC-GF in NHL and breast cancer patients in accordance with national quality guidelines. More than 200 clinics participated, with 871 survey responses collected. Participating physicians reviewed national level program results and discussed findings through a live clinical forum and webcasts. Customized benchmarking reports comparing practice-specific results to national survey data in the USA are available to participants via Onmark’s online web portal at www.onmarkservices.com.
A second phase of the programme began in January 2009 to study prescribing patterns and clinical rationale behind the use of WBC-GF for NHL patients receiving CHOP and CHOP-R chemotherapy. Onmark is also piloting a project to collect information on WBC-GF use in 27 regimens across four diagnoses directly through Lynx Mobile. The project will provide clinicians with point-of-care education around guidelines to consider when selecting patient treatments.
“Onmark’s IQ Program enables oncology providers to assess their clinical treatment patterns and compare to those of practitioners nationwide,” said IQ participant Dr. Ted Arrowsmith of Chattanooga Oncology Hematology Associates. “As healthcare reimbursement shifts toward a performance-based model, access to this level of information is critical to improve the value and quality of patient care.”
Facilitated through McKesson’s industry-leading Lynx Mobile technology, the IQ Program uses clinically-triggered queries to gather information from physicians on why treatment decisions are made. Practice-level results are provided to participating physicians, comparing their performance to established quality of care standards and other practices nationwide. More than 250 clinics are participating in at least one of the three IQ programs currently available to Onmark members, including a new program that collects information on stage IIIb-IV NSCLC, focusing on patients eligible for or currently receiving bevacizumab or erlotinib as part of their treatment plan. Additional IQ Program opportunities covering a variety of disease states and therapies are planned.
“The primary goal of IQ Programs is to provide actionable information to Onmark members,” stated Mike Cunningham, PharmD, vice president and general manager of GPO and Information Services for McKesson Specialty Care Solutions. “Participating practices gain insight into how their treatment patterns align with national quality guidelines, which will ultimately better prepare them for pay-for-performance programs and empower high-quality patient care.” |
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