Grant: Fellowship - PA: Clinical Research

Febrile neutropenia (FN), defined as a low count of neutrophils which are white blood cells involved in helping the immune system fight infection in combination with fever, is a common, potentially life-threatening complication of chemotherapy in lymphoma patients, and often requires hospitalization. The Canadian Institute for Health Information reports that hematologic malignancies, such as lymphoma, were one of the fifteen most expensive medical conditions in Canada in 2005 with respect to acute, inpatient medical costs; a large part of these costs were attributable to complications including neutropenia. Information on how patients prefer to be treated for FN and economic evaluations of interventions used to prevent FN will help to increase the effectiveness and efficiency of Canadian healthcare system. My research focuses on two areas related to the delivery of health services to lymphoma patients who are at risk of developing FN or who develop this condition: 1) examining factors that influence patient preferences for treatment of FN in hospital or at home as well as how FN affect patients' quality of life; and 2) conducting cost-effectiveness evaluations of filgrastim and pegfilgrastim, medications used to prevent FN. Lymphoma patients suffering from FN will be asked to complete questionnaires on their quality of life and on how different factors, (e.g., out-of-pocket expenses) would affect whether they choose to be treated at home. A decision model, combing information on costs, patient preferences and clinical effectiveness will be used to estimate the cost-effectiveness of the two strategies available to prevent FN. I expect the results of this study will be highly relevant to healthcare decision makers as they can be used to formulate policy on improving the delivery of high quality, cost-effective care to lymphoma patients with FN.