Evaluation of Antiemetic Practices for Prevention of Chemotherapy-induced Nausea and Vomiting (CINV): Results of a European Oncology Nurse Survey

Dielenseger, Pascale; Börjeson, Sussanne; Vidall, Cheryl; Young, Annie; Jahn, Patrick

doi:10.1093/annonc/mdx388.012

Cited by 5 publications

(11 citation statements)

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“…Another limitation is that antiemetic prophylaxis was only analyzed for the acute phase following chemotherapy. Consistent with previous reports, lower rates of guideline adherence would be expected for the delayed phase [25,28,33,34]. Analysis of patient records for delayed CINV prophylaxis would provide a more detailed picture of prescription patterns in the real world for the overall CINV risk period.…”

Section: Discussionsupporting

confidence: 76%

“…Adherence to 2006 MASCC/ESMO guidelines was analyzed in a prospective observational study enrolling patients at various centers across Europe and showed a 55% adherence rate in the acute phase, with lowest adherence in the HEC (43%) and AC (32%) settings. Similar prospective and retrospective studies in Europe and the U.S. [26–28] as well as surveys of oncologists [32] and oncology nurses [33, 34] consistently showed low compliance with antiemetic guidelines.…”

Section: Discussionmentioning

confidence: 63%

“…Complex administration schedules have been reported to interfere with use of guideline-recommended antiemetics [32,34]. Some contributing factors include nursepatient miscommunication during the explanation of complex schedules, and the desire of some patients to reduce the pill burden, leading them to only take their medication once symptoms appear.…”

Section: Discussionmentioning

confidence: 99%

“…In the above‐mentioned oncologists’ survey [32], only approximately a third of European oncologists reported awareness of MASCC/ESMO guidelines. Low guideline awareness was also reported by oncology nurses in Europe [34] and the U.S. [33], with only 40% and 6%, respectively, noting familiarity with MASCC/ESMO guidelines. Similarly, low uptake of the NK 1 RA–5‐HT 3 RA–dexamethasone triplet for prophylaxis of carboplatin AUC ≥4‐mg/mL per minute regimens in the U.S. may reflect low awareness of changes in guidelines [29].…”

Section: Discussionmentioning

confidence: 99%

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Practice Patterns for Prevention of Chemotherapy-Induced Nausea and Vomiting and Antiemetic Guideline Adherence Based on Real-World Prescribing Data

et al. 2021

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Background. Guideline-recommended antiemetic prophylaxis improves nausea and vomiting control in most patients undergoing chemotherapy. Multinational Association of Supportive Care in Cancer/European Society for Medical Oncology (MASCC/ESMO) antiemetic guidelines recommend prophylaxis with a neurokinin-1 receptor antagonist (NK 1 RA), a 5-hydroxytryptamine-3 (5-HT 3)RA, and dexamethasone for patients receiving highly emetogenic chemotherapy (HEC), including anthracycline-cyclophosphamide (AC)-and carboplatin (considered moderately emetogenic chemotherapy)-based chemotherapy. Here, we analyze the use of NK 1 RA-5-HT 3 RA-dexamethasone for antiemetic prophylaxis associated with HEC and carboplatin. Methods. The data source was the Global Oncology Monitor (Ipsos Healthcare). Geographically representative physicians from France, Germany, Italy, Spain, and UK were screened for treatment involvement and number of patients treated/month. Patients' data from Jan-Dec 2018 were collected from medical charts and extrapolated on the basis of the total number of physicians who prescribe chemotherapy. The emetic risk of chemotherapy was classified per MASCC/ESMO guidelines. Results. Data from 45,324 chemotherapy-treated patients were collected, representing a total extrapolated prevalence of 1,394,848 chemotherapy treatments included in the analysis. NK 1 RAs were used in 45%/42%/19% of patients receiving cisplatin-/AC-/carboplatin-based chemotherapy, respectively; 18%/24%/7% received the guidelinerecommended NK 1 RA-5-HT 3 RA-dexamethasone combination; no antiemetics were prescribed for 12% of the treatments. Often, physicians' perception of the emetic risk of chemotherapy did not follow MASCC/ESMO guideline classification. Conclusion. Low adherence to antiemetic guidelines was revealed in clinical practice in five European countries, with 15% of all HEC-/carboplatin-based treatments receiving guideline-recommended NK 1 RA-5-HT 3 RA-dexamethasone prophylaxis, and 12% of them receiving no antiemetics. New strategies for improving guideline adherence are urgently needed. The Oncologist 2021;9999:• • Implications for Practice: Despite recent advances in antiemetic therapy, a substantial proportion of patients experience nausea and vomiting associated with chemotherapy in daily clinical practice. Antiemetic guidelines aim at prevention of chemotherapy-induced nausea and vomiting (CINV) and guideline-consistent antiemetic therapy can effectively prevent vomiting and, to a lesser extent, nausea in most patients with cancer. This study reports low adherence to antiemetic guidelines in the highly emetogenic chemotherapy setting in daily clinical practice across five European countries. Opportunity

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Practice Patterns for Prevention of Chemotherapy-Induced Nausea and Vomiting and Antiemetic Guideline Adherence Based on Real-World Prescribing Data

et al. 2021

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“…This alarming result may be explained by clinicians' marked underestimation of the emetic potential of chemotherapy and by their lack of understanding of antiemetic guidelines. Relevant surveys in Europe and US of oncologists 24 and oncology nurses 25 consistently reported low compliance with antiemetic guidelines. Considering about that NK-1RAs are not included for medical insurance reimbursement yet in China as well as their expensive price, so these drugs are di cult to access.…”

Section: Discussionmentioning

confidence: 99%

A cross-sectional study on the guideline adherence to antiemetic regimens for chemotherapy-induced nausea and vomiting: A single center retrospective study of 1000 patients.

Luo¹,

Chen²,

Xu³

et al. 2021

Preprint

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Background Chemotherapy-induced nausea and vomiting (CINV) is a common symptom in patients who undergoing chemotherapy, it is very important to control CINV to maintain dose intensity and patients' quality of life. To analyze the current situation of CINV for the tumor patients who undergoing chemotherapy, we used a cross-sectional survey to assess CINV status in those patients, and whether the drugs used by doctors in each department met the guidelines, and compared the incidence of acute and delayed CINV overall post-chemotherapy periods. Methods This was a single-center, cross-sectional retrospective study of patients with chemotherapy discharged from different departments of Zhejiang Cancer Hospital in China. Participants reported the occurrence, severity, and impact on daily life of nausea and vomiting from the day of chemotherapy administration up to 5 days, and physicians collected the clinical data from the medical records. Results Data were collected from 875 responses totally. In this study, the overall incidence rate of CINV was 44.34%, acute CINV was 24.57%, and delayed CINV was 39.66%. 19.89% patients had both acute and delayed CINV. The consistency rates of antiemetic with guideline in different departments showed significant gap between the actual usage of drugs and the recommended guidelines (P=0.001). In 875 patients, 518 patients received guideline recommended antiemetic regimen, the CINV rates of complete control (CC), defined as the absence of any symptoms, were 61.58%. While the CC rates in other 357 patients were 47.06%(P<0.001). Conclusion Overall, clinician adherence to antiemetic guideline recommendations in different departments remained poorly characterized with varying degrees. Future studies should focus on the complete rate as a primary end point rather than complete remission. The standardized management of CINV in patients need to be further strengthened and doctors need to use drugs more regularly to reduce the occurrence of CINV in patients.

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Prevention of chemotherapy-induced nausea and vomiting in the real-world setting in Spain

et al. 2021

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Purpose Proper monitoring and management of chemotherapy-induced nausea and vomiting (CINV) with antiemetics is crucial for cancer patients. This study aimed to evaluate the use of antiemetics for the treatment of highly emetogenic chemotherapy (HEC) including carboplatin in the real-world setting in Spain. Methods A representative panel of cancer specialists was asked to collect information about the antiemetic treatments provided to patients receiving chemotherapy. Records formed part of the Global Oncology Monitor© database (Ipsos Healthcare, London, UK). Chemotherapy data were extrapolated using Ipsos Healthcare’s projection methodology. Results A total of 73 experts were finally included. Data from 9519 patients, estimated to be representative of 202,084 patients, were collected. HEC (and carboplatin-based chemotherapy) was administered to 73,118 (36%) patients, cisplatin-based therapy being the most frequent treatment (n = 34,649, 47.38%). Neurokinin-1 receptor antagonists (NK1RAs) alone or in combination were used as prophylaxis for CINV in 14,762 (20%) patients, while the combination of NK1RA with 5-hydroxytryptamine-3 receptor antagonist (5-HT3RAs) and dexamethasone as recommended by the international guidelines was used in 5849 (8%) patients only. No antiemetic prophylaxis was administered to 8.46% of the patients receiving HEC (n = 6189). Physicians classified cisplatin-, anthracycline-cyclophosphamide (AC-), and carboplatin-based regimens as HEC in 63%, 22% and 4% of the cases, respectively. Conclusions The use of NK1RA-containing regimens for CINV prevention in patients treated with HEC was less than expected, suggesting poor adherence to international antiemetic guidelines.

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Evaluation of Antiemetic Practices for Prevention of Chemotherapy-induced Nausea and Vomiting (CINV): Results of a European Oncology Nurse Survey

Cited by 5 publications

References 0 publications

Practice Patterns for Prevention of Chemotherapy-Induced Nausea and Vomiting and Antiemetic Guideline Adherence Based on Real-World Prescribing Data

Practice Patterns for Prevention of Chemotherapy-Induced Nausea and Vomiting and Antiemetic Guideline Adherence Based on Real-World Prescribing Data

A cross-sectional study on the guideline adherence to antiemetic regimens for chemotherapy-induced nausea and vomiting: A single center retrospective study of 1000 patients.

Prevention of chemotherapy-induced nausea and vomiting in the real-world setting in Spain

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