Is delayed chemotherapy-induced emesis well managed in oncological clinical practice?

Fabi, Alessandra; Barduagni, M.; Lauro, Salvatore; Portalone, Luigi; Mauri, Mariella; Marinis, Filippo de; C, Narduzzi; Tonini, Giuseppe; Giampaolo, Marianna; Pacetti, Umberto; Paoloni, Francesca; Cognetti, Francesco

doi:10.1007/s00520-002-0427-3

Cited by 49 publications

(18 citation statements)

References 14 publications

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“…CINV is considered to be one of the most severe and feared adverse effects of cancer treatment by patients and can have a significant impact on QOL. 370,[374][375][376] Standard of care antiemetics for managing CINV have changed considerably in the last 5 years, thus many of the trials evaluating integrative approaches are not tested with the newest and most effective standard treatment regimen. 197,371 Most contemporary studies use as the endpoint the proportion of patients achieving a complete response, defined as no emesis or use of rescue medication.…”

Section: Yoga (B Grade)mentioning

confidence: 99%

Clinical practice guidelines on the evidence‐based use of integrative therapies during and after breast cancer treatment

Greenlee

DuPont-Reyes

Balneaves³

et al. 2017

CA A Cancer J Clinicians

581

459

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Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided.

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Section: Yoga (B Grade)mentioning

confidence: 99%

Clinical practice guidelines on the evidence‐based use of integrative therapies during and after breast cancer treatment

Greenlee

DuPont-Reyes

Balneaves³

et al. 2017

CA A Cancer J Clinicians

581

459

View full text Add to dashboard Cite

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“…Only 43% of patients treated with highly emetogenic cytotoxic, 64% of patients treated with moderately emetogenic cytotoxicity, and 31% of the patients treated with low-emetogenic cytotoxic agents received the correct antiemetic treatment for delayed-type vomiting. Moreover, 68% of the patients received unnecessary antiemetic treatment [5].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Adherence to Chemotherapy-Induced Nausea and Vomiting Guidelines. An Observational Study

Almazrou¹,

Alnaim²

2012

JCT

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Objective: To describe the prescribing trends of antiemetics in chemotherapy-induced nausea and vomiting (CINV), assess adherence to American Society of Clinical Oncology (ASCO) guidelines, and evaluate the effectiveness of prescribed antiemetics. Additionally, we also sought to explore barriers that hinder clinical practice guideline (CPG) implementation. Methods: One hundred fifty-five patients between the ages of 18 and 60 who were admitted to the haematology/oncology department/clinic to receive intravenous chemotherapy, either as in-patients or outpatients, were enrolled in a prospective observational study. Relevant patient demographic data, chemotherapy protocols and antiemetics were collected. Chemotherapies were classified according to their emetogenic potential. This information was used to assess whether the antiemetic prescribed matched the emetogenic risk of treatment. The analysis of outcomes was performed using the MASCC antiemetic assessment tool. Key Findings: The results showed that 95% of antiemetic prescription pre-chemotherapy regimens did not adhere to the guidelines. The findings were use of twice the recommended dose of granisetron (87.7%), overuse granisetron (16%) and metoclopramide (62.6%), and underuse dexamethasone (27%) and corticosteroid duplication (7.7%). With respect to post-chemotherapy antiemetic prescriptions, 91% of prescriptions were not adherent to guidelines, with overuse of granisetron (81.9%) and metoclpramide (34.2%) and underuse of dexamethasone (66.5%) being the most frequently reported trends. Conclusion: This study shows a lack of conformity to antiemetic guidelines, resulting mainly in overtreatment. Although vomiting was well-managed, nausea remains under controlled and requires additional medical attention. The lack of knowledge and motivation are considered barriers to CPG implementation

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“…This is in stark contrast to what has been observed in the literature where adherence to delayed CINV prophylaxis has been reported to be poor [5–8, 21]. The utilized system minimizes the need for most providers to independently consider the specific combination and dosing of antiemetics for each chemotherapy regimen and decreases the underuse of antiemetic prophylaxis for both acute and delayed CINV.…”

Section: Discussionmentioning

confidence: 89%

Antiemetic prescribing practices using a computerized physician order entry system

Kadakia

Leal

Seisler

et al. 2013

Support Care Cancer

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Purpose Adherence to guideline-consistent chemotherapy-induced nausea and vomiting (CINV) prophylaxis is suboptimal. The primary aim of this study was to evaluate the magnitude of compliance to institutional guideline-directed antiemetic prophylaxis using a computerized physician order entry system at a single tertiary care institution. A nurse survey was also performed to evaluate how oncology practices, within a cooperative group, managed clinician orders for the prevention of CINV. Methods The electronic medical records of 100 consecutive patients were evaluated. The primary endpoint was the incidence of compliance to provide all aspects of scheduled institutional guideline-directed antiemetic prophylaxis for acute (day 1) and delayed (days 2–4) CINV. A descriptive analysis was performed on the convenience sample. Logistic regression was completed to determine the predictors of noncompliance. Results The incidence of compliance on days 1–4 was 94 %. Half of the noncompliant events (three of six, 50 %) occurred on day 1 alone and involved patients receiving low-emetogenic chemotherapy. There was a high degree of compliance to institutional guidelines for the treatment of delayed CINV (97 %). Patients receiving minimally emetogenic and moderately emetogenic chemotherapy (N =70) were observed to be 100 % compliant. Patients receiving doxorubicin/cyclophosphamide were numerically less likely to receive institutional guidelines, compared to patients receiving other chemotherapy regimens (OR, 0.24 (0.04, 1.36), p value, 0.05). The nurse survey suggested significant variability amongst the involved institutions with regards to antiemetic prescribing practices. Conclusions Computerized physician order entry is associated with impressive adherence to clinician-prescribing practices, according to institutional guidelines, for acute and delayed CINV.

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Is delayed chemotherapy-induced emesis well managed in oncological clinical practice?

Cited by 49 publications

References 14 publications

Clinical practice guidelines on the evidence‐based use of integrative therapies during and after breast cancer treatment

Clinical practice guidelines on the evidence‐based use of integrative therapies during and after breast cancer treatment

Evaluation of Adherence to Chemotherapy-Induced Nausea and Vomiting Guidelines. An Observational Study

Antiemetic prescribing practices using a computerized physician order entry system

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