No abstract

No abstract

PurposeChemotherapy/radiotherapy-induced nausea and vomiting (CINV/RINV) can affect half of oncology patients, significantly impacting daily life. Nausea without vomiting has only recently been thought of as a condition in its own right. As such, the incidence of nausea is often underestimated. This survey investigated the incidence and impact of CINV/RINV in patients compared with estimations of physicians/oncology nurses to determine if there is a perceptual gap between healthcare professionals and patients.MethodsAn online research survey of physicians, oncology nurses and patients was conducted across five European countries. Participants had to have experience prescribing/recommending or have received anti-emetic medication for CINV/RINV treatment. Questionnaires assessed the incidence and impact of CINV/RINV, anti-emetic usage and compliance, and attribute importance of anti-emetic medication.ResultsA total of 947 (375 physicians, 186 oncology nurses and 386 patients) participated in this survey. The incidence of nausea was greater than vomiting: 60 % of patients reported nausea alone, whereas 18 % reported vomiting. Physicians and oncology nurses overestimated the incidence of CINV/RINV but underestimated its impact on patients’ daily lives. Only 38 % of patients reported full compliance with physicians’/oncology nurses’ guidelines when self-administering anti-emetic medication. Leading factors for poor compliance included reluctance to add to a pill burden and fear that swallowing itself would induce nausea/vomiting.ConclusionsThere is a perceptual gap between healthcare professionals and patients in terms of the incidence and impact of CINV/RINV. This may lead to sub-optimal prescription of anti-emetics and therefore management of CINV/RINV. Minimising the pill burden and eliminating the requirement to swallow medication could improve poor patient compliance with anti-emetic regimens.Electronic supplementary materialThe online version of this article (doi:10.1007/s00520-015-2750-5) contains supplementary material, which is available to authorized users.

Despite emerging evidence for the clinical and financial efficacy of the clinical nurse specialist (CNS), the provision of this role is patchy across the country. There is also a risk that incumbent CNS' may be redirected to less specialist work in trusts that do not appreciate the full value of the service that these nurses provide. Optimal and equitable patient access to CNS care will require the development of a strong evidence base showing that specialist nurses not only deliver patient-focused care, but that they can also help to meet healthcare managers' objectives of streamlined, cost-effective clinical services.

No abstract

As nurses play a key role in the prevention, detection, and management of extravasations, they should also assume a key role in ensuring that their local protocols include all appropriate management strategies. Where appropriate, if Savene is not included in the treatment guidelines, nurses should feel empowered to encourage their trust and Specialist Commissioning Groups (SCGs) to make it available, and thus minimise the serious risks associated with anthracycline extravasations.

No abstract

VIDALL C. (2010) European Journal of Cancer Care19, 29–34
Providing community oral chemotherapy services A plethora of oral chemotherapeutic agents have been introduced in recent years leading to new challenges for chemotherapy services, especially in supporting patients to manage their treatment safely in their own homes. Recent UK documents have highlighted patient safety issues with oral chemotherapy, underlining the principle that oral chemotherapy should be managed to the same standards as intravenous chemotherapy. In order to help address these issues, independent health care providers have developed collaborative programmes working with National Health Service Cancer Centres to provide care locally and deliver cancer treatments to patient's homes. Some of the key objectives of these home services are optimal patient education, contact with chemotherapy trained home nurses, toxicity management and adherence with therapy, while maintaining the clinical responsibility for the patient's overall care with the Consultant oncologist at the Cancer Centre. The provision of oral chemotherapy drugs using this or similar models of care, offers a more cost effective way for the purchasers of healthcare services to deliver an effective oral chemotherapy service. This is facilitated by preferable taxation arrangements in the UK for medication delivered to the patient's own home which reduces both cost and demand on acute hospital facilities, and greatly improves the quality of life for patients who no longer need to make frequent and prolonged visits to hospital for their treatment to be prescribed and dispensed.