Adherence to antiemetic guidelines and control of chemotherapy-induced nausea and vomiting (CINV) in a large hospital

Caracuel, F; Muñoz, Nuria Muñoz; Baños, U; Ramírez, Gloria

doi:10.1177/1078155214524809

Cited by 22 publications

(17 citation statements)

References 21 publications

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“…Younger patients in our study were at higher risk for CINV occurrence, which is consistent with the literature data 1 2 5. It was established that the gender influenced CINV control opposite to the literature data, as women showed lower risk for CINV occurrence 1 2 5.…”

Section: Discussionsupporting

confidence: 93%

“…Aapro et al discovered 55% and 46% of patients received antiemetic therapy consistent with the Guidelines during acute and delayed phases, respectively 17. Similar results were also observed by Caracuel et al 1. Our results showed higher consistency with the Guidelines for the acute phase (80.6%), but lower for the delayed phase (0%) due to the discrepancies in the prescription of corticosteroids.…”

Section: Discussionsupporting

confidence: 88%

“…During cancer treatment, many patients experience chemotherapy-induced nausea and vomiting (CINV), which leads to lower quality of life and poorer adherence to subsequent chemotherapy cycles 1 2. It depends on chemotherapy-related risk factors, such as chemotherapy emetogenic potential, dosage, route of administration, duration of intravenous chemotherapy and number of chemotherapy cycles, as well as other, mainly patient-related risk factors 2–4.…”

Section: Introductionmentioning

confidence: 99%

“…However, according to studies performed in various clinical settings, low adherence to these guidelines was reported 1 8 9…”

Section: Introductionmentioning

confidence: 99%

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Control of chemotherapy-induced nausea and vomiting in patients with gastrointestinal tumours

2016

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ObjectivesDuring cancer treatment, many patients experience chemotherapy-induced nausea and vomiting (CINV), which leads to a lower quality of life and poorer adherence to the subsequent chemotherapy cycles. The aim of the study was to assess antiemetic therapy prescribing and CINV control in the acute phase (24 hours post-chemotherapy) and the delayed phase (days 2–4 post-chemotherapy). Factors influencing CINV control were also determined.MethodsInformation on antiemetic premedication was gathered from patient medical records. Data regarding antiemetic therapy post-discharge and CINV control were in both phases obtained using patient questionnaires. Antiemetic therapy prescribing was compared with internal CINV prevention and control guidelines. Predictive factors for CINV control were evaluated using binary logistic regression.ResultsThere were 62 patients enrolled in the study, out of which 50 (80.6%) received adequate antiemetic premedication. In the acute phase, 46 (74.2%) patients reported well-controlled CINV, whereas 16 (25.8%) reported uncontrolled CINV. None of the patients was prescribed post-discharge antiemetic therapy as per guidelines. In the delayed phase, CINV was more frequent as 39 (62.9%) patients reported well-controlled CINV, whereas uncontrolled CINV was reported in 23 (37.1%) patients. The predictive factors for overall CINV control were prescription of corticosteroids (OR=9.025, p=0.019) and patient age (OR=0.851, p=0.002). The delayed CINV control was dependent on age (OR=0.885, p=0.030) and acute CINV control (OR=17.377, p=0.001).ConclusionsThe majority of the patients were prescribed adequate antiemetic therapy for the acute phase but not for the delayed phase, which may have resulted in more patients experiencing delayed CINV.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

“…However, according to studies performed in various clinical settings, low adherence to these guidelines was reported 1 8 9…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Control of chemotherapy-induced nausea and vomiting in patients with gastrointestinal tumours

2016

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“…Antiemetic drugs should be administered before chemotherapy and used during the entire risk period for CINV as suggested. Despite the proven success of these guidelines in reducing the rates of CINV, studies conducted in several countries have documented a low rate of adherence (13)(14)(15)(16)(17)(18)(19)(20). Given that China is the most populous country in the world and that it has a significant cancer burden, it is imperative that Chinese health authorities have a comprehensive understanding of the country's current practices of antiemetic therapy.…”

Section: Original Articlementioning

confidence: 99%

Patterns of antiemetic prophylaxis for chemotherapy-induced nausea and vomiting in China

Zong¹,

Zhang²,

Ji³

et al. 2016

Chinese Journal of Cancer Research

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Background: Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting (CINV) at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods:We searched the China Health Insurance Research Association (CHIRA) Database to identify patients with cancer who were ≥18 years old and received either moderately or highly emetogenic chemotherapy (MEC and HEC, respectively) between 2008 and 2012. Patients' characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics.Results: Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC (59.4% vs. 81.3%; P<0.001). The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group (P≤0.012); however, a higher proportion received a mixed regimen containing corticosteroids (P≤0.007). Although more than half of the patients in the HEC group took three antiemetics to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group (both P<0.001).Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic.Conclusions: These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.

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A cost-utility analysis of risk model-guided versus physician’s choice antiemetic prophylaxis in patients receiving chemotherapy for early-stage breast cancer: a net benefit regression approach

Thavorn

Coyle

Hoch

et al. 2017

Support Care Cancer

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Adherence to antiemetic guidelines and control of chemotherapy-induced nausea and vomiting (CINV) in a large hospital

Abstract: Our study confirms low adherence with both local and international recommendations for antiemetic prescriptions. However, we could not prove that adherence involves a CINV reduction. Adherence did not seem to be influenced by the doctor's perception of the patient's risk of emesis.

Cited by 22 publications

References 21 publications

Control of chemotherapy-induced nausea and vomiting in patients with gastrointestinal tumours

Control of chemotherapy-induced nausea and vomiting in patients with gastrointestinal tumours

Patterns of antiemetic prophylaxis for chemotherapy-induced nausea and vomiting in China

A cost-utility analysis of risk model-guided versus physician’s choice antiemetic prophylaxis in patients receiving chemotherapy for early-stage breast cancer: a net benefit regression approach

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