OBJECTIVES: Febrile neutropenia (FN) is a serious side effect of strong chemotherapy. Pegfilgrastim prophylaxis reduces the incidence of FN and should be administered at least 24 hours after myelosuppressive chemotherapy. Pegfilgrastim can be administered by manual injection using a prefilled syringe (PFS) or a more recently available on-body injector (OBI) applied at the end of chemotherapy with automatic administration of pegfilgrastim approximately 27 hours later. The study objective was to explore the practical implementation of PFS and OBI in the clinic setting.

METHODS: Trained data collectors observed clinic processes and staff time associated with pegfilgrastim administration via PFS and OBI application.

RESULTS: Data from two sites provided information from 28 nurses on administration of pegfilgrastim via PFS to 53 patients (19 first-time patients) and application of the OBI to 75 patients (16 first-time patients). Mean (95% CI) clinic staff time was 5.7 minutes (4.2–7.2) for PFS administration and 7.3 minutes (6.3–8.4) for OBI application. The mean (95% CI) time for OBI first-time application, 13.8 minutes (10.1–17.4), was reduced to 5.6 minutes (5.3–5.9) for subsequent applications. After arriving at the clinic, the mean (95% CI) patient wait time for next-day PFS administration was 35.3 minutes (15.9–54.7).

CONCLUSIONS: From a patient’s perspective, PFS administration required a return clinic visit the day after chemotherapy, resulting in significant wait time at the clinic- time not required for patients receiving pegfilgrastim via OBI. From a clinic’s perspective, individual patient visits needed to be accommodated for PFS administration- visits not required for patients receiving pegfilgrastim via OBI. OBI application time was significantly less for subsequent versus first-time patients, likely due to a reduced need for education on the device. Use of the OBI for pegfilgrastim prophylaxis may reduce the overall time burden for both patients and clinics.