{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T03:53:42Z","timestamp":1747194822132,"version":"3.40.5"},"reference-count":18,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncology Practice"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec><jats:title>PURPOSE:<\/jats:title><jats:p> Practice guidelines recommend the prophylactic use of granulocyte colony\u2013stimulating factors (G-CSFs) in patients with high risk of febrile neutropenia, but evidence suggests that G-CSFs are frequently overused. The objectives of this study were (1) to determine the prevalence and prescribing patterns of G-CSF and (2) to evaluate the impact of a program initiative on G-CSF prescribing patterns, adherence to guidelines, and mortality. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p> In this retrospective cohort study, data were used from the electronic health records of patients with metastatic colorectal cancer who received care at a multicenter oncology practice network during two time periods: July 01, 2013, to December 31, 2014, and July 01, 2017, to December 31, 2017. Beginning 2016, a site-wide program initiative that involved educational materials, appropriate nonuse recommendations, and prior authorization was introduced in the oncology practice network with an aim of reducing G-CSF overutilization. Descriptive statistics, t tests, and chi-squared tests were employed to analyze program impact. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p> There were 3,426 chemotherapy regimens corresponding to 2,968 patients. There were a total of 387 (11.3%) G-CSF\u2013treated patients and 3,095 G-CSF administrations during the study period. G-CSF use was significantly lower in the postperiod, compared with the preperiod ( P &lt; .0001). Adherence to guidelines was significantly higher in the postperiod, compared with the preperiod ( P &lt; .0001). Mortality rates did not significantly differ between the two time periods. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION:<\/jats:title><jats:p> This study demonstrates that policy initiatives have the potential to positively affect G-CSF prescription patterns and promote guideline adherence. These findings could help prescribers adopt a cost-effective approach in patients with metastatic colorectal cancer, leading to enhanced clinical practice and value-based care. <\/jats:p><\/jats:sec>","DOI":"10.1200\/op.20.01045","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T20:36:09Z","timestamp":1618432569000},"page":"e1830-e1836","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":5,"title":["Impact of a G-CSF Policy to Reduce Low-Value Care on Guideline Adherence and Mortality"],"prefix":"10.1200","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2335-0121","authenticated-orcid":false,"given":"Chinelo C.","family":"Orji","sequence":"first","affiliation":[{"name":"Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6976-7686","authenticated-orcid":false,"given":"Carolyn M.","family":"Brown","sequence":"additional","affiliation":[{"name":"Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1345-3503","authenticated-orcid":false,"given":"J. 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