Abstract

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.

DOI

10.1016/j.clon.2008.12.004

Publication Date

2009-05-01

Publication Title

Clin Oncol (R Coll Radiol)

Volume

21

Issue

4

First Page

320

Last Page

328

ISSN

0936-6555

Organisational Unit

School of Health Professions

Keywords

Antineoplastic Agents, Antineoplastic Combined Chemotherapy Protocols, Carboplatin, Databases as Topic, Focus Groups, Health Care Surveys, Humans, Neoplasms, Practice Patterns, "Physicians'", Qualitative Research, Surveys and Questionnaires, United Kingdom

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