Variation in supportive care practices in hematopoietic cell transplantation. Biol Blood Marrow Transplant 2008 Nov;14(11):1231-8
Date
10/23/2008Pubmed ID
18940677Pubmed Central ID
PMC3304538DOI
10.1016/j.bbmt.2008.08.008Scopus ID
2-s2.0-53749104934 (requires institutional sign-in at Scopus site) 46 CitationsAbstract
Hematopoietic cell transplantation is an elective procedure that results in prolonged immune suppression and high treatment-related morbidity and mortality. Transplant centers and physicians use a variety of prophylaxis and monitoring strategies to prevent or minimize complications. Little is known about the variability in these practices. We conducted an international Internet-based survey of 526 physicians to describe the spectrum of supportive care practices employed. Consistency in pretransplant cardiac (96%) and pulmonary (95%) screening, informed consent documentation (93%), and use of antifungal prophylaxis (92%) was observed. Greater heterogeneity was seen in use of myelogenous growth factors, empiric antibiotic therapy, protective isolation procedures, posttransplant monitoring, and environmental and social restrictions. Although some practice differences were associated with physician characteristics and transplant type, most practice variation remained unexplained. These results suggest a need for well-designed observational and interventional studies to provide data about which supportive care practices improve outcomes. For practices proved to be beneficial, publication of guidelines and incorporation of monitoring into quality improvement initiatives may help standardize practices.
Author List
Lee SJ, Astigarraga CC, Eapen M, Artz AS, Davies SM, Champlin R, Jagasia M, Kernan NA, Loberiza FR Jr, Bevans M, Soiffer RJ, Joffe SAuthor
Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Data Collection
Elective Surgical Procedures
Female
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Monitoring, Physiologic
Physicians
Practice Patterns, Physicians'
