Difference of compliance rates for the recommendations in Japanese Guideline on Febrile Neutropenia according to respondents\u2019 attributes: the second report on a questionnaire survey among hematology-oncology physicians and surgeons

Nobu Akiyama,Isao Yoshida,Hitoshi Kusaba,Takuho Okamura,Toshiaki Saeki,Keitaro Fukushima,Minoru Yoshida,Kosuke Takahashi,Shingo Yano,Shun-Ichi Kimura,Sadamoto Zenda,Kazuo Tamura,Hiromichi Iwasaki,Yasushi Takamatsu,Hiroyuki Fujita

doi:10.1007/s00520-022-06834-9

Abstract

PurposeThe Japanese Society of Medical Oncology (JSMO) published a guideline (GL) on febrile neutropenia (FN) in 2017. This study aims to identify promoting factors and disincentives for complying with GL recommendations according to attributes of doctors providing chemotherapy.MethodsA questionnaire survey was conducted with SurveyMonkey™ for physician members of the Japanese Association of Supportive Care in Cancer and relevant academic organizations. Each question had four options (always do, do in more than half of patients, do in less than half, do not at all) and a free description form. Responses were analyzed according to the respondents’ attributes.ResultSeven hundred eighty-eight out of retrieved 801 responses were available for analysis. Multivariable analysis demonstrated that the percentage of GL users was higher among women and Japanese Society of Clinical Oncology members. The overall compliance rate was higher among women, JSMO members, and board-certified medical oncologists. Internists emphasized the significance of collecting blood cultures at FN onset, and surgeons stressed the importance of G-CSF prophylaxis. Hematologists were less likely to adhere to recommendations on risk assessment of FN by the Multinational Association of Supportive Care in Cancer score and administration of gammaglobulin products. However, those are acceptable due to the characteristics of their practice. Eight recommendations had no difference in compliance rates between users and non-users, some of whose statements were ambiguous and discretionary.ConclusionWomen were more likely to use and adhere to GL. The recommendations should be developed considering the characteristics of specialty and subspecialty and avoiding ambiguity and discretionary statements.

Highlights

We previously published the first report of a questionnaire survey on penetration and application of the Japanese Guidelines (GL) on febrile neutropenia (FN), and revised the second edition published by the Japanese Society of Medical Oncology (JSMO) [1]
Some of them are feared to deteriorate the quality of FN management, such as the risk assessment of FN with the Multinational Association of Supportive Care in Cancer (MASCC) score at onset (Q2), administration of therapeutic G-CSF (Q11), and primary prophylactic G-CSF(Q16) (Table 1, Supple Table)
Do you know the Clinical Guidelines on Febrile Neutropenia revised 2nd version published from the Japanese Society of Medical Oncology in 2017?

Summary

Introduction

We previously published the first report of a questionnaire survey on penetration and application of the Japanese Guidelines (GL) on febrile neutropenia (FN), and revised the second edition published by the Japanese Society of Medical Oncology (JSMO) [1]. It demonstrated that 86.7% of respondents knew and used GL; the medians of the complete. Do you know the Clinical Guidelines on Febrile Neutropenia revised 2nd version published from the Japanese Society of Medical Oncology in 2017?

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