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Taxanes for Ovarian Cancer: Progress Report

Taxanes for Ovarian Cancer: Progress Report. Rosemary Tate Projects Co-ordinator January 2001. Aims and Objectives (1). To quantify proportion of patients with a newly diagnosed, histologically confirmed ovarian cancer who received chemotherapy in 1998 compared with 2000

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Taxanes for Ovarian Cancer: Progress Report

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  1. Taxanes for Ovarian Cancer:Progress Report Rosemary Tate Projects Co-ordinator January 2001 March 2001

  2. Aims and Objectives (1) • To quantify proportion of patients with a newly diagnosed, histologically confirmed ovarian cancer who received chemotherapy in 1998 compared with 2000 • To determine the proportion of patients who received taxane-based chemotherapy as first/second/third line chemotherapy March 2001

  3. Aims and Objectives (2) • To describe the patterns of yearly taxane prescribing across the different Health Authorities of N & Y • To identify the circumstances under which taxanes were given, e.g. in a cancer centre/unit, as part of a trial/protocol • To investigate reasons for any variation in the use of taxanes March 2001

  4. Data Required • Complete regional coverage • Diagnosis • Patient-based • Chemotherapeutic agents prescribed • Chemotherapeutic line (1st, 2nd, 3rd) • Clinical trial, name, arm March 2001

  5. Data Sources Investigated • Registry data • Regional Pharmacists • Medicare Audit UK database • Northern Gynaecological Oncology Group (NGOG) database • Clinicians’ own data • Trust/hospital Pharmacy data March 2001

  6. Registry Ovarian Cancer Data(September 2000, excluding certain paths., private & ER hospitals)) N.B. Chemotherapeutic agents, trials and line data not recorded March 2001

  7. Medicare Audit Data • 95% UK coverage of overall prescribing patterns • Covers several high-cost drugs, listed by specialty, Trust • May be made up at one hospital, but prescribed at another • Trials and line data not recorded March 2001

  8. MEDICARE AUDIT DATA Up to Feb 2000 March 2001

  9. Medicare Data - Missing Trusts Airedale ) Calderdale ) Dewsbury ) Newcastle-upon-Tyne Hospitals ) do not North Durham ) prescribe Northumbria ) Taxanes? Priority Healthcare Wearside ) Sunderland ) Tees and North East Yorks ) York ) North East Lincs ) not in our Scunthorpe and Goole ) region? March 2001

  10. NGOG Database • 16/27 Northern hospitals submit data • Patient-based data from Jan 1997 • Diagnostic, FIGO staging, Trials data included • Chemotherapy type unreliably recorded • Clinician compliance disappointing • Changing to data entry at clinical interface March 2001

  11. Clinicians’ patients receiving Taxol 1998-2000 • List of 11 Northern clinicians’ named patients with dates prescribed and costs • 30/53 patients identified on Registry database as having ovarian cancer diagnosis • Cost per patient varied from £1,026 to £11,437 (Mean £5690, SD £2960) • Administered for mean of 67 days and up to 121 days March 2001

  12. Clinicians’ patients receiving Taxol 1998-2000 • Patients prescribed Taxol 7 months to 12.5 years after diagnosis, mean 3.5 years • 12/30 (40%) who received Taxol 1998 - 2000 were diagnosed 1998 - 2000 • 1/30 (3%) chemotherapy date = Taxol date (7 months after diagnosis) • 15/30 (50%) patients now dead, given Taxol in year preceding death March 2001

  13. Trust/Hospital Pharmacy Data Held • 30/31 (97%) Pharmacies returned completed questionnaires • 18/30 (60%) reported that they prescribed taxanes 1998 - 2000 • 8 (44%) had paper records only • 3 (17%) had electronic records only • variation in software used (Ascribe used by 3) • 6 (33%) had paper and electronic records • 1 (6%) had no records of taxane prescribing March 2001

  14. Trust/Hospital Pharmacy Data Items (N = 18) • 87% Patient name • 76% Chemotherapy type • 74% Clinician name • 36% Trials details • 31% NHS No • 28% Patient diagnosis • 20% Chemotherapy line no. • 6% Clinical stage March 2001

  15. Pharmacy Departments Prescribing Taxanes up to Sept/Oct 2000 PRESENT ON MEDICARE: Leeds General Infirmary St Jamess University Hospital (Leeds) Princess Royal (Hull) Huddersfield Royal Bradford Royal Cumberland Infirmary (Carlisle) Pinderfields General Queen Elizabeth (Gateshead) Hartlepool General Darlington Memorial South Cleveland Newcastle General Harrogate District NOT PRESENT ON MEDICARE:: Airedale General South Tyneside District Sunderland Royal Scunthorpe General Diana Princess of Wales (Grimsby) March 2001

  16. Pharmacy Department Comments (13/18 or 72%) • missing information can be obtained from clinician involved (28%) • could cross-reference with other data sources to cope with lack of diagnosis/staging info. but would involve “mammoth task of paper sorting” (22%) • only one consultant prescribes taxanes for ovarian cancer in our hospital (17%) March 2001

  17. March 2001

  18. Plans for the Main Study • Ask Steering Group for names of prescribing clinicians • Simultaneously ask pharmacies to complete a q’naire re prescribing information • Download data from registry for all of 2000 (repeat downloads) • Match information and send postal q’naire to clinicians on Taxane use • Casenote validation (all/sample?) March 2001

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