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Background: Most studies of racial and ethnic disparities in health care have focused on technical aspects of care, such as diagnostics or therapies while less is known about ethnic differences in accepting a novel medical device. Neulasta Onpro kit eliminates the need for an additional clinic visit for pts receiving chemotherapy. Given the ethnically diverse population in our institution, we investigated acceptance of Onpro kit among cancer pts on chemotherapy. Methods: Single-institution, retrospective review was conducted of pts with predominantly GI tumors who received kit within 1 hour of completion of systemic chemotherapy from Jan 2014 through Jan 2018. Clinic and nursing notes, and pharmacy records were reviewed to identify pts who refused Onpro kit and to discern reasons for refusal. Results: Total 238 orders for kit were voided amongst 68 pts. Median age was 60 years (range 32-87) with 46% of pts ≥ 65. Ethnicities included: Caucasian 41; African American 7; Spanish 3 and Asian 17. Overall, 15/68 pts refused kit (22%). Among them, 13/15 were Asian, 2 Caucasian. Overall, 87% pts were Asian. The reasons for refusal described were: dislike of bulky attachment to their skin, request to place kit on their stomach and not on their arm, having trepidation over unwitnessed administration of drug, fear of reaction, disposal at home, fear of pain and lack of confirmation of proper dose administration and need for MRI. Conclusions: While Onpro kit is an attractive alternative 22% of our pts with voided orders, mainly of Asian backgrounds, declined its application. In 2017, we presented first study in GI malignancies to report the safety and efficacy of same-day administration of manual (subcutaneous) pegfilgrastim. We believe the current study represents the first study to look at important ethnic differences in accepting kit. This study detected ethnic differences and supports importance of cultural factors in determining therapies chosen. Consideration of pts' cultural heritage may facilitate communication between physicians and pts to achieve optimal cancer care. It would be interesting to look at experience or market share of manufacturer in Asian countries. Moreover, translated pt brochures and videos could be very helpful.

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Author Details

Valerie Relias

Tufts Medical Center, Boston, MA

Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Health Services Research, Clinical Informatics, and Quality of Care

Track

Quality Care/Health Services Research

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Abstract Disclosure