TY - JOUR
T1 - A national survey investigating UK prescribers' opinions on chemotherapy dosing and 'dose-banding'.
AU - Kaestner, SA
AU - Sewell, GJ
PY - 2009/5
Y1 - 2009/5
N2 - AIMS: The primary purpose of dose-banding for cancer chemotherapy is to reduce patient waiting times, but dose-banding also has additional benefits, such as reduced drug wastage, reduced stress for staff, and prospective quality control of infusions. However, the uptake of dose-banding seems fairly low. Possible reasons for this are a reluctance to use dose-banding for clinical reasons or a lack of awareness. Despite the seemingly minor change from established practice of dose preparation, dose-banding has the potential to alter patient chemotherapy exposure. The aim of this study was to investigate prescribers' awareness of dose-banding and their opinions on the scope and limitations of dose-banding in the context of UK chemotherapy services. MATERIALS AND METHODS: This survey was performed throughout the UK by use of a postal questionnaire, which was validated before national distribution to 1104 oncologists and haematologists. The questionnaire contained both quantitative and qualitative elements. A database was created for data entry and analysis. RESULTS: The response from prescribers was encouraging for a postal questionnaire, with a 35% response rate (387 responses). Many were aware of the concept of dose-banding (>80%) and were also supportive of the system. The weakness around body surface area-based dosing was a commonly discussed topic. However, opinions on which is the maximum acceptable deviation from the prescribed dose with dose-banding were controversial, and there was a concern about the lack of evidence to support the use of dose-banding. The views on whether carboplatin and targeted therapies should be dose-banded were also divided. CONCLUSIONS: There was general support for dose-banding, but concerns about the lack of an evidence base could be a barrier to the wider introduction of the system. Consequently, more clinical studies are required to justify the safety and efficacy of dose-banding, and also to evaluate whether dose-banding is acceptable within clinical trials.
AB - AIMS: The primary purpose of dose-banding for cancer chemotherapy is to reduce patient waiting times, but dose-banding also has additional benefits, such as reduced drug wastage, reduced stress for staff, and prospective quality control of infusions. However, the uptake of dose-banding seems fairly low. Possible reasons for this are a reluctance to use dose-banding for clinical reasons or a lack of awareness. Despite the seemingly minor change from established practice of dose preparation, dose-banding has the potential to alter patient chemotherapy exposure. The aim of this study was to investigate prescribers' awareness of dose-banding and their opinions on the scope and limitations of dose-banding in the context of UK chemotherapy services. MATERIALS AND METHODS: This survey was performed throughout the UK by use of a postal questionnaire, which was validated before national distribution to 1104 oncologists and haematologists. The questionnaire contained both quantitative and qualitative elements. A database was created for data entry and analysis. RESULTS: The response from prescribers was encouraging for a postal questionnaire, with a 35% response rate (387 responses). Many were aware of the concept of dose-banding (>80%) and were also supportive of the system. The weakness around body surface area-based dosing was a commonly discussed topic. However, opinions on which is the maximum acceptable deviation from the prescribed dose with dose-banding were controversial, and there was a concern about the lack of evidence to support the use of dose-banding. The views on whether carboplatin and targeted therapies should be dose-banded were also divided. CONCLUSIONS: There was general support for dose-banding, but concerns about the lack of an evidence base could be a barrier to the wider introduction of the system. Consequently, more clinical studies are required to justify the safety and efficacy of dose-banding, and also to evaluate whether dose-banding is acceptable within clinical trials.
KW - Antineoplastic Agents
KW - Antineoplastic Combined Chemotherapy Protocols
KW - Carboplatin
KW - Databases as Topic
KW - Focus Groups
KW - Health Care Surveys
KW - Humans
KW - Neoplasms
KW - Practice Patterns
KW - Physicians'
KW - Qualitative Research
KW - Surveys and Questionnaires
KW - United Kingdom
UR - https://pearl.plymouth.ac.uk/context/hp-research/article/1101/viewcontent/2009_20A_20national_20survey_20of_20UK_20prescribers_20opinions_20on_20Chemotherapy_20Dosing_20and_20Dose_banding._20_20Clinical_20Oncology_202009__2021__20320_328..pdf
U2 - 10.1016/j.clon.2008.12.004
DO - 10.1016/j.clon.2008.12.004
M3 - Article
SN - 0936-6555
VL - 21
SP - 320
EP - 328
JO - Clin Oncol (R Coll Radiol)
JF - Clin Oncol (R Coll Radiol)
IS - 4
ER -