Assessment of adherence to the guidelines for the management of nausea and vomiting induced by chemotherapy

França, Monique Sedlmaier; Usón, Pedro L uiz Serrano; Antunes, Yuri P hilippe Pimentel V ieira; Prado, Bernard Lobato; Donnarumma, Carlos del Cistia; Mutão, Taciana Sousa; Rodrigues, H.; Giglio, Auro del

doi:10.1590/s1679-45082015ao3097

Cited by 11 publications

(9 citation statements)

References 11 publications

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“…In this study, low rates of adherence to the NCCN guideline were found, similar to what was reported by other authors who assessed agreement with the guidelines for prophylaxis of CINV. [7][8][9][10] In the study by Beauchemin et al, although they included only young patients using antineoplastic agents of moderate and high emetogenic potential, only 36.1% of them received antiemetic therapy according to international guidelines. 7 Nikbakht et al also found a low rate of adherence to the guidelines, especially for the protocols of moderate and high emetogenicity.…”

Section: Resultsmentioning

confidence: 99%

“…9 Finally, França et al identified low adherence (22%) to the ASCO guideline in the prescriptions of antiemetics of patients exposed to chemotherapy of minimum, low, moderate, and high emetogenic potential in the setting of a Brazilian private hospital and, unlike other authors, found greater adherence in prescriptions containing highly emetogenic chemotherapy. 10 The only PRPh identified in the prescriptions for prophylaxis of acute phase of protocols with high emetogenic potential was the prescription of dexamethasone in underdose (16.7%).…”

Section: Resultsmentioning

confidence: 99%

“…The authors emphasized that the use of excessive doses makes treatment more expensive and does not benefit symptom control. 10 Protocols with moderate emetogenic potential are known to be associated with a significant incidence of late nausea and vomiting, justifying the use of antiemetics in this phase. 3 In this study, the main PRPhs identified were longer duration of treatment with ondansetron (26.2%), need for additional medication (23.7%) when no antiemetics were prescribed, and therapeutic duplicity when both (dexamethasone and ondansetron) were prescribed (12.5%).…”

Section: Resultsmentioning

confidence: 99%

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Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital

Lázaro¹,

Carlotto²,

Rotta³

2020

Rev Bras Farm Hosp Serv Saude

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Peer review: blind reviewer and Annemeri Livinallli Objectives: To assess if the antiemetic prophylaxis prescribed to patients exposed to chemotherapy is following the Antiemesis guideline published by the National Comprehensive Cancer Network (NCCN) version 3.2018. Methods: A medication review was performed, considering antiemetic´s prescriptions of adult patients under treatment with moderate and high emetogenic potential antineoplastic agents, assisted on an outpatient basis in a tertiary public hospital, from May to September 2019. The information contained in the prescriptions was compared with the guideline recommendations in relation to the selection of the therapeutic class of the antiemetic, dose, route of administration, dosage regimen and duration of treatment, with the prophylaxis expected for the acute and delayed phases being evaluated. Results: Were included 87 patients, 38 and 49 of whom used chemotherapy drugs with high and moderate emetogenic potential, respectively. In the prescriptions containing highly emetogenic chemotherapeutic agents, the antiemetic therapy recommended for acute phase prophylaxis was incorrectly prescribed for 9 patients (23.7%), and the problem encountered was dexamethasone underdose (16.7%). In the delayed phase, problems were identified in the prescriptions of 35 patients (92.1%), including the prescription of inappropriate medication (57.4%), since the prescription contained ondansetron, not foreseen by the guideline at this stage, and the need for dexamethasone as an additional drug (18.5%). For 22 patients (44.9%) exposed to moderately emetogenic antineoplastic agents, the acute regimen was incorrectly prescribed, and the main problems identified were dexamethasone overdose (21.2%) and the need for dexamethasone as an additional drug (5.0%). Delayed antiemetic prophylaxis was incorrectly prescribed for 45 of them (91.8%), with ondansetron treatment duration longer than recommended (26.2%), need for dexamethasone or ondansetron as an additional medication (23.7%) and therapeutic duplicity (12.5%) the problems encountered. Conclusion: It is suggested the implementation of strategies aimed at increasing adherence to the guideline's recommendations by the prescribers, as well as access to medicines considered essential.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital

Lázaro¹,

Carlotto²,

Rotta³

2020

Rev Bras Farm Hosp Serv Saude

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“…Compared to the use of corticosteroids, 5-HT3 receptor antagonists were prescribed for almost 98% of patients being treated for acute and delayed CINV in both the HEC and MEC groups. Overuse of 5-HT3 receptor antagonists may not be specific to China, as this type of non-compliance was documented in a recent study in Brazil (26). Moreover, approximately 20% of patients were treated with more than one 5-HT3 receptor antagonist or corticosteroid, even though this prescribing habit is not recommended by either guideline.…”

Section: Discussionmentioning

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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“…Overuse of 5-HT3 receptor antagonists was documented in a previous study in Brazil. 18 Although continuing ondansetron alone beyond 24 h has a minor role in the control of delayed CINV in patients who received HEC, 19 the benefit has not been as great as that seen with dexamethasone monotherapy. 20 Furthermore, the addition of a 5-HT3 receptor antagonist beyond 24 h along with glucocorticoids did not significantly improve control of delayed emesis as compared with dexamethasone monotherapy.…”

Section: Discussionmentioning

confidence: 99%

Adherence to guidelines on prophylaxis of chemotherapy-induced nausea and vomiting in the National Cancer Institute, Sudan

2017

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Objective: To evaluate the adherence to American Society of Clinical Oncology (ASCO) guidelines for antiemetic prophylaxis of chemotherapy-induced nausea and vomiting and assess the outcomes of the prescribed antiemetic drugs. Methods: This prospective, observational study enrolled chemotherapy-naive cancer patients who were admitted to the National Cancer Institute between May and July 2015 for intravenous chemotherapy. Patient’s demographic data, chemotherapy protocols and types of antiemetic drugs were collected by reviewing patients’ files, chemotherapy prescription forms and interviewing the patients. Results: The data revealed that 90% of pre-chemotherapy antiemetic prescriptions did not adhere to antiemetic guidelines. The trends of non-adherence included an overuse of ondansetron (14%), under-prescribing of dexamethasone (16%) and corticosteroid duplication (14%). Regarding antiemetic use for the prevention of delayed emesis, the data showed that 90% of antiemetic prescriptions were non-adherent with ASCO guidelines, with overuse of ondansetron (20%) and metoclopramide (37%) and lack of dexamethasone prescriptions (80%) on days 2 and 3 being the most frequently reported trends. The percentage of patients with complete response (no emesis or rescue therapy) over 5 days post chemotherapy was 36%. Conclusion: The study indicated an extremely low adherence rate to ASCO guidelines for antiemetic prophylaxis of chemotherapy-induced nausea and vomiting. Non-adherence included a trend of both underuse and overuse of indicated antiemetic medications.

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Assessment of adherence to the guidelines for the management of nausea and vomiting induced by chemotherapy

Cited by 11 publications

References 11 publications

Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital

Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital

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

Adherence to guidelines on prophylaxis of chemotherapy-induced nausea and vomiting in the National Cancer Institute, Sudan

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