Patient and physician characteristics associated with erythropoiesis-stimulating agent use in patients with myelodysplastic syndromes |
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Authors: | Davidoff Amy J Weiss Smith Sheila Baer Maria R Ke Xuehua Bierenbaum Jason M Hendrick Franklin McNally Diane L Gore Steven D |
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Affiliation: | Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland 21201, USA. adavidof@rx.umaryland.edu |
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Abstract: | Patient and physician characteristics associated with use of erythropoiesis-stimulating agents in myelodysplastic syndrome patients have not yet been described. Myelodysplastic syndrome patients diagnosed from 2001 to 2005 were identified from the Surveillance Epidemiology and End Results-Medicare database. Multivariate regressions examined the association between patient and physician characteristics and the probability of receiving any erythropoiesis-stimulating agents, and of receiving therapeutic-length (≥ 8 week) treatment episodes. Among the 6,588 myelodysplastic syndrome patients studied, 65% received erythropoiesis-stimulating agents. Use of erythropoiesis-stimulating agents was lower for blacks compared to whites (OR 0.78; 95% CI:0.61-0.99), single persons compared to married (OR 0.77; 95% CI:0.62-0.97), Medicaid recipients (OR 0.66; 95% CI:0.55-0.79), and those living in census tracts with lower educational attainment. Patients who did not consult a hematology-oncology specialist were less likely to receive erythropoiesis-stimulating agents. Specialist access, financial resources and mobility are key determinants of receipt of erythropoiesis-stimulating agents among myelodysplastic syndrome patients. |
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Keywords: | erythropoiesis-stimulating agent myelodys-plastic syndromes patient physician characteristics |
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