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Patrick Jahn - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of antiemetic practices for prevention of chemotherapy-induced nausea and vomiting (CINV): results of a European oncology nurse survey
Supportive Care in Cancer, 2019Co-Authors: Pascale Dielenseger, Sussanne Börjeson, Cheryl Vidall, Annie Young, Patrick JahnAbstract:IntroductionPreventing CINV is possible when guideline-recommended Antiemetics are used. Because oncology nurses play a critical role in risk assessment and management of CINV, a survey of European nurses was conducted to evaluate antiemetic practices, assess awareness of and adherence to current guideline recommendations, and explore barriers to adherence.MethodsFrom March 2016 to Feb 2017, 212 oncology nurses in 16 European countries completed a 20-question online survey.ResultsRespondents had 15-year (median) oncology nursing experience, and most (75%) were able to suggest or prescribe Antiemetics. Most (80%) worked in the public not-for-profit hospital setting. Guideline awareness was generally low with nurses most familiar with ASCO (46%) and MASCC/ESMO (40%) guidelines; individual institution guidelines were most commonly used (47%). Key discrepancies between reported antiemetic use and guideline recommendations in the highly emetogenic chemotherapy (HEC) setting were underutilization of the recommended NK_1RA + 5-HT_3RA + steroid combination on day 1 (55%) and high use of 5-HT_3RAs (50%) on days 2–5 when a steroid (63% use) should be used. Metoclopramide use was high in both HEC and moderately emetogenic settings, with ~ 30% and ~ 50% reporting use on day 1 and days 2–5, respectively. The most common reported barrier to use of guideline-recommended agents was physician preference (40%). The most common challenges in managing CINV were “controlling nausea/vomiting in the delayed phase” (64%) and “reducing the impact of CINV on patients’ quality-of-life” (61%).ConclusionsThis survey highlights opportunities to improve utilization of guideline-recommended Antiemetics, thereby optimizing prevention of CINV and QoL for patients receiving emetogenic chemotherapy.
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evaluation of antiemetic practices for prevention of chemotherapy induced nausea and vomiting cinv results of a european oncology nurse survey
Supportive Care in Cancer, 2019Co-Authors: Pascale Dielenseger, Sussanne Börjeson, Cheryl Vidall, Annie Young, Patrick JahnAbstract:Preventing CINV is possible when guideline-recommended Antiemetics are used. Because oncology nurses play a critical role in risk assessment and management of CINV, a survey of European nurses was conducted to evaluate antiemetic practices, assess awareness of and adherence to current guideline recommendations, and explore barriers to adherence. From March 2016 to Feb 2017, 212 oncology nurses in 16 European countries completed a 20-question online survey. Respondents had 15-year (median) oncology nursing experience, and most (75%) were able to suggest or prescribe Antiemetics. Most (80%) worked in the public not-for-profit hospital setting. Guideline awareness was generally low with nurses most familiar with ASCO (46%) and MASCC/ESMO (40%) guidelines; individual institution guidelines were most commonly used (47%). Key discrepancies between reported antiemetic use and guideline recommendations in the highly emetogenic chemotherapy (HEC) setting were underutilization of the recommended NK1RA + 5-HT3RA + steroid combination on day 1 (55%) and high use of 5-HT3RAs (50%) on days 2–5 when a steroid (63% use) should be used. Metoclopramide use was high in both HEC and moderately emetogenic settings, with ~ 30% and ~ 50% reporting use on day 1 and days 2–5, respectively. The most common reported barrier to use of guideline-recommended agents was physician preference (40%). The most common challenges in managing CINV were “controlling nausea/vomiting in the delayed phase” (64%) and “reducing the impact of CINV on patients’ quality-of-life” (61%). This survey highlights opportunities to improve utilization of guideline-recommended Antiemetics, thereby optimizing prevention of CINV and QoL for patients receiving emetogenic chemotherapy.
Jorn Herrstedt - One of the best experts on this subject based on the ideXlab platform.
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fosaprepitant for the prevention of chemotherapy induced nausea and vomiting
Expert Review of Anticancer Therapy, 2012Co-Authors: Christina H Ruhlmann, Jorn HerrstedtAbstract:For patients receiving cancer chemotherapy, the ongoing development of antiemetic treatment is of significant importance. Patients consider nausea and vomiting among the most distressing symptoms of chemotherapy, and as new Antiemetics have been very successful in prevention of vomiting, agents effective against nausea have become one of the major unmet needs. The neurokinin (NK)1 receptor antagonist aprepitant potentiates the antiemetic efficacy of the combination of a serotonin receptor antagonist and a corticosteroid. Fosaprepitant (intravenous prodrug of aprepitant) given as a single intravenous dose of 150 mg can replace the aprepitant 3-day oral regimen. This article focuses on the development and clinical application of fosaprepitant.
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Antiemetics: an update and the MASCC guidelines applied in clinical practice
Nature Clinical Practice Oncology, 2008Co-Authors: Jorn HerrstedtAbstract:Nausea and vomiting are two of the most severe problems for patients treated with chemotherapy. Until the late 1970s, nausea and vomiting induced by chemotherapy was an almost neglected research area. With the introduction of cisplatin, the cytotoxin with the highest emetic potential, research was stimulated and has now resulted in the development of two new classes of Antiemetics, the serotonin and neurokinin antagonists. A large number of trials have fine-tuned antiemetic therapy and made evidence-based recommendations possible for the majority of patients receiving chemotherapy. This Review discusses the pathophysiology of nausea and vomiting, the development of Antiemetics, highlights some of the newest Antiemetics, and finally summarizes recommendations from the evidence-based guidelines developed by the Multinational Association of Supportive Care in Cancer. Although the pathophysiology of nausea and vomiting is still not completely elucidated, the increased understanding of the basic mechanisms has advanced the clinical development of Antiemetics Corticosteroids are useful Antiemetics; recently, the development of serotonin antagonists and the neurokinin antagonist, aprepitant, have resulted in a significant decrease in the number of vomiting episodes experienced by patients receiving emetogenic chemotherapy Treatment of the nausea associated with emetogenic chemotherapy is still a major problem Evidence-based guidelines for antiemetic treatment have been developed and are updated on a regular basis; implementation of these guidelines should be encouraged Promising results from phase II studies, of dexamethasone plus different two-drug combinations of the new serotonin antagonist, palonosetron, the neurokinin antagonist, aprepitant, and the antipsychotic agent, olanzapine, require verification in large randomized trials A large number of trials have improved antiemetic therapy and made evidence-based recommendations possible for the majority of patients receiving chemotherapy. This Review discusses the pathophysiology of nausea and vomiting, the development of Antiemetics, highlights some of the newest Antiemetics, and finally summarizes recommendations from the evidence-based guidelines developed by the Multinational Association of Supportive Care in Cancer.
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Antiemetics: an update and the MASCC guidelines applied in clinical practice.
Nature clinical practice. Oncology, 2008Co-Authors: Jorn HerrstedtAbstract:Nausea and vomiting are two of the most severe problems for patients treated with chemotherapy. Until the late 1970s, nausea and vomiting induced by chemotherapy was an almost neglected research area. With the introduction of cisplatin, the cytotoxin with the highest emetic potential, research was stimulated and has now resulted in the development of two new classes of Antiemetics, the serotonin and neurokinin antagonists. A large number of trials have fine-tuned antiemetic therapy and made evidence-based recommendations possible for the majority of patients receiving chemotherapy. This Review discusses the pathophysiology of nausea and vomiting, the development of Antiemetics, highlights some of the newest Antiemetics, and finally summarizes recommendations from the evidence-based guidelines developed by the Multinational Association of Supportive Care in Cancer.
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risk benefit of Antiemetics in prevention and treatment of chemotherapy induced nausea and vomiting
Expert Opinion on Drug Safety, 2004Co-Authors: Jorn HerrstedtAbstract:The development of effective antiemetic prophylaxis is one of the most significant steps forward in the area of supportive care. Fifteen years ago, patients receiving chemotherapy had to face the fact that nausea and vomiting were inevitable adverse effects, which could only be partially prevented by treatment with Antiemetics such as dopamine (DA) D2 receptor antagonists and corticosteroids. The first group of drugs specifically developed as Antiemetics was the serotonin (5-hydroxytryptamine [5-HT]3) receptor antagonists. These drugs have dramatically improved prophylaxis of chemotherapy-induced emesis, particularly when used in combination with a corticosteroid. This combination has resulted in a significant decrease in the number of patients vomiting, whereas the improvement in the prophylaxis of nausea has been less successful. Another group of Antiemetics, the neurokinin (NK)1 receptor antagonists, has recently been developed, and the first drug in this class, aprepitant, has been approved by the FDA...
Anthony L. Kovac - One of the best experts on this subject based on the ideXlab platform.
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Postoperative Nausea and Vomiting in Pediatric Patients
Pediatric Drugs, 2021Co-Authors: Anthony L. KovacAbstract:Postoperative nausea and vomiting (PONV), postoperative vomiting (POV), post-discharge nausea and vomiting (PDNV), and opioid-induced nausea and vomiting (OINV) continue to be causes of pediatric morbidity, delay in discharge, and unplanned hospital admission. Research on the pathophysiology, risk assessment, and therapy for PDNV, OINV and pain therapy options in children has received increased attention. Multimodal pain management with the use of perioperative regional and opioid-sparing analgesia has helped decrease nausea and vomiting. Two common emetogenic surgical procedures in children are adenotonsillectomy and strabismus repair. Although PONV risk factors differ between adults and children, the approach to decrease baseline risk is similar. As PONV and POV are frequent in children, antiemetic prophylaxis should be considered for those at risk. A multimodal approach for antiemetic and pain therapy involves preoperative risk evaluation and stratification, antiemetic prophylaxis, and pain management with opioid-sparing medications and regional anesthesia. Useful Antiemetics include dexamethasone and serotonin 5-hydroxytryptamine-3 (5-HT3) receptor antagonists such as ondansetron. Multimodal combination prophylactic therapy using two or three Antiemetics from different drug classes and propofol total intravenous anesthesia should be considered for children at high PONV risk. “Enhanced recovery after surgery” protocols include a multimodal approach with preoperative preparation, adequate intravenous fluid hydration, opioid-sparing analgesia, and prophylactic Antiemetics. PONV guidelines and management algorithms help provide effective postoperative care for pediatric patients.
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Postoperative and Postdischarge Nausea and Vomiting After Ambulatory Surgery: An Update
Current Anesthesiology Reports, 2014Co-Authors: Anthony L. KovacAbstract:Patients undergoing ambulatory surgery have similar, but also different nausea and vomiting stimuli and mechanisms than inpatients. As the emphasis on “street readiness” and discharge home is a unique and important concern for outpatients, various medications, formulations, techniques, risk scores, and guidelines have been introduced to help improve the care of patients having ambulatory surgery. Additional research and data have been obtained regarding the effects of postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) on ambulatory anesthesia. More effective antiemetic combination techniques and new long-acting Antiemetics have been introduced for PONV and PDNV prevention. Antiemetic drug selection for ambulatory surgery depends on efficacy, cost, adverse effects, and ease of dosing. Safety concerns include adverse events such as the ECG QTc prolongation effects of Antiemetics. To help guide antiemetic drug selection, techniques, and therapy, the PONV consensus guidelines were updated in 2014.
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Update on the Management of Postoperative Nausea and Vomiting
Drugs, 2013Co-Authors: Anthony L. KovacAbstract:New antiemetic drug developments, formulations, guidelines, risk evaluation, and controversies have occurred in the area of postoperative nausea and vomiting (PONV). These developments have helped improve our understanding of the prevention and treatment of PONV in the postanesthesia care unit and after discharge home or to the hospital ward. Antiemetic drug research has resulted in the introduction of the second-generation 5-hydroxytryptamine-3 (5-HT_3) receptor antagonist palonosetron and the neurokinin-1 (NK-1) receptor antagonist aprepitant, as well as new data on existing Antiemetics. The next frontier and need for further nausea and vomiting research and therapy is the area of postdischarge nausea and vomiting after the patient is discharged home from phase II of the ambulatory stepdown unit or to the hospital ward. Antiemetic drug selection depends on efficacy, cost, safety, and ease of dosing. Safety concerns have arisen regarding the side effects of Antiemetics, specifically their effect on the ECG with prolongation of the QTc interval by the butyrophenones and the first-generation 5-HT_3 receptor antagonist class of Antiemetics. The impact of pharmocogenetics on antiemetic drug metabolism and their resulting efficacy has been correlated with genetic makeup affecting drug response. A discussion of ethics in PONV research has been initiated by the meta-analysis of PONV studies. To help guide antiemetic selection and PONV therapy for clinical practitioners, the Society of Ambulatory Anesthesia (SAMBA) PONV consensus guidelines have been introduced and updated.
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Management of Postoperative Nausea and Vomiting in Children
Pediatric Drugs, 2007Co-Authors: Anthony L. KovacAbstract:Postoperative nausea and vomiting (PONV) continues to be a frequent and important cause of morbidity in children. Postoperative vomiting (POV) is more commonly studied in children than postoperative nausea because of a child’s inability to effectively express distress after experiencing nausea. POV is problematic in children and is one of the leading postoperative complaints from parents and the leading cause of readmission to the hospital. POV occurs twice as frequently in children as in adults, increasing until puberty and then decreasing to adult incidence rates. Gender differences are not seen before puberty. POV remains a main cause of morbidity in children because severe vomiting can be associated with dehydration, postoperative bleeding, pulmonary aspiration, and wound dehiscence. While children have an increased potential for dehydration and the resulting physiologic impairments, other associated results such as a delay in hospital discharge or an overnight or longer hospital admission also must be considered. The two most common emetogenic surgical procedures evaluated in children are strabismus repair and adenotonsillectomy. The approach to the management of PONV and POV in children is similar to that in adults. However, as the rate of POV is more frequent in children than in adults, more children are candidates for antiemetic prophylaxis. The management approach is multifactorial and involves proper preoperative preparation, risk stratification, rational selection of antiemetic prophylaxis, choice of anesthesia technique, and a plan for postoperative antiemetic therapy. It is important to identify children at moderate-to-high risk for POV as prophylactic antiemetic therapy is useful in these children. Antiemetics of choice for POV in children include dexamethasone, dimenhydrinate, perphenazine, ondansetron, dolasetron, granisetron, and tropisetron. The serotonin (5-hydroxytryptamine; 5-HT_3) antagonists are the antiemetic drugs of first choice for POV prophylaxis in children because as a group they have greater efficacy for preventing vomiting than nausea. The 5-HT_3 antagonists can be effectively combined with dexamethasone with an increase in efficacy. If possible, regional anesthesia should be considered. For those undergoing general anesthesia, the baseline POV risk should be reduced. Children at moderate-to-high PONV risk should receive combination therapy with two or three prophylactic Antiemetics from different antiemetic drug classes. Reference to and the use of PONV guidelines and management algorithms help improve cost-effective postoperative care.
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Prevention and Treatment of Postoperative Nausea and Vomiting
Drugs, 2000Co-Authors: Anthony L. KovacAbstract:Pain, nausea and vomiting are frequently listed by patients as their most important perioperative concerns. With the change in emphasis from an inpatient to outpatient hospital and office-based medical/surgical environment, there has been increased interest in the ‘big little problem’ of postoperative nausea and vomiting (PONV). Currently, the overall incidence of PONV is estimated to be 25 to 30%, with severe, intractable PONV estimated to occur in approximately 0.18% of all patients undergoing surgery. PONV can lead to delayed postanaesthesia care unit (PACU) recovery room discharge and unanticipated hospital admission, thereby increasing medical costs. The aetiology and consequences of PONV are complex and multifactorial, with patient-, medical- and surgery-related factors. A thorough understanding of these factors, as well as the neuropharmacology of multiple emetic receptors [dopaminergic, muscarinic, cholinergic, opioid, histamine, serotonin (5-hydroxy-tryptamine; 5-HT)] and physiology [cranial nerves VIII (acoustic-vestibular), IX (glossopharyngeal) and X (vagus), gastrointestinal reflex] relating to PONV are necessary to most effectively manage PONV. Commonly used older, traditional Antiemetics for PONV include the anticholinergics (scopolamine), phenothiazines (promethazine), antihistamines (diphenhydramine), butyrophenones (droperidol) and benzamides (metoclopramide). These Antiemetics have adverse effects such as dry mouth, sedation, hypotension, extrapyramidal symptoms, dystonic effects and restlessness. The newest class of Antiemetics used for the prevention and treatment of PONV are the serotonin receptor antagonists (ondansetron, granisetron, tropisetron, dolasetron). These Antiemetics do not have the adverse effects of the older, traditional Antiemetics. Headache and dizziness are the main adverse effects of the serotonin receptor antagonists in the dosages used for PONV. The serotonin receptor antagonists have improved antiemetic effectiveness but are not as completely efficacious for PONV as they are for chemotherapy-induced nausea and vomiting. Older, traditional Antiemetics (such as droperidol) compare favourably with the serotonin receptor antagonists regarding efficacy for PONV prevention. Combination antiemetic therapy improves efficacy for PONV prevention and treatment. In the difficult-to-treat PONV patient (as in the chemotherapy patient), suppression of numerous emetogenic peripheral stimuli and central neuroemetic receptors may be necessary. This multimodal PONV management approach includes use of: (i) multiple different antiemetic medications (double or triple combination antiemetic therapy acting at different neuroreceptor sites); (ii) less emetogenic anaesthesia techniques; (iii) adequate intravenous hydration; and (iv) adequate pain control.
Pascale Dielenseger - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of antiemetic practices for prevention of chemotherapy-induced nausea and vomiting (CINV): results of a European oncology nurse survey
Supportive Care in Cancer, 2019Co-Authors: Pascale Dielenseger, Sussanne Börjeson, Cheryl Vidall, Annie Young, Patrick JahnAbstract:IntroductionPreventing CINV is possible when guideline-recommended Antiemetics are used. Because oncology nurses play a critical role in risk assessment and management of CINV, a survey of European nurses was conducted to evaluate antiemetic practices, assess awareness of and adherence to current guideline recommendations, and explore barriers to adherence.MethodsFrom March 2016 to Feb 2017, 212 oncology nurses in 16 European countries completed a 20-question online survey.ResultsRespondents had 15-year (median) oncology nursing experience, and most (75%) were able to suggest or prescribe Antiemetics. Most (80%) worked in the public not-for-profit hospital setting. Guideline awareness was generally low with nurses most familiar with ASCO (46%) and MASCC/ESMO (40%) guidelines; individual institution guidelines were most commonly used (47%). Key discrepancies between reported antiemetic use and guideline recommendations in the highly emetogenic chemotherapy (HEC) setting were underutilization of the recommended NK_1RA + 5-HT_3RA + steroid combination on day 1 (55%) and high use of 5-HT_3RAs (50%) on days 2–5 when a steroid (63% use) should be used. Metoclopramide use was high in both HEC and moderately emetogenic settings, with ~ 30% and ~ 50% reporting use on day 1 and days 2–5, respectively. The most common reported barrier to use of guideline-recommended agents was physician preference (40%). The most common challenges in managing CINV were “controlling nausea/vomiting in the delayed phase” (64%) and “reducing the impact of CINV on patients’ quality-of-life” (61%).ConclusionsThis survey highlights opportunities to improve utilization of guideline-recommended Antiemetics, thereby optimizing prevention of CINV and QoL for patients receiving emetogenic chemotherapy.
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evaluation of antiemetic practices for prevention of chemotherapy induced nausea and vomiting cinv results of a european oncology nurse survey
Supportive Care in Cancer, 2019Co-Authors: Pascale Dielenseger, Sussanne Börjeson, Cheryl Vidall, Annie Young, Patrick JahnAbstract:Preventing CINV is possible when guideline-recommended Antiemetics are used. Because oncology nurses play a critical role in risk assessment and management of CINV, a survey of European nurses was conducted to evaluate antiemetic practices, assess awareness of and adherence to current guideline recommendations, and explore barriers to adherence. From March 2016 to Feb 2017, 212 oncology nurses in 16 European countries completed a 20-question online survey. Respondents had 15-year (median) oncology nursing experience, and most (75%) were able to suggest or prescribe Antiemetics. Most (80%) worked in the public not-for-profit hospital setting. Guideline awareness was generally low with nurses most familiar with ASCO (46%) and MASCC/ESMO (40%) guidelines; individual institution guidelines were most commonly used (47%). Key discrepancies between reported antiemetic use and guideline recommendations in the highly emetogenic chemotherapy (HEC) setting were underutilization of the recommended NK1RA + 5-HT3RA + steroid combination on day 1 (55%) and high use of 5-HT3RAs (50%) on days 2–5 when a steroid (63% use) should be used. Metoclopramide use was high in both HEC and moderately emetogenic settings, with ~ 30% and ~ 50% reporting use on day 1 and days 2–5, respectively. The most common reported barrier to use of guideline-recommended agents was physician preference (40%). The most common challenges in managing CINV were “controlling nausea/vomiting in the delayed phase” (64%) and “reducing the impact of CINV on patients’ quality-of-life” (61%). This survey highlights opportunities to improve utilization of guideline-recommended Antiemetics, thereby optimizing prevention of CINV and QoL for patients receiving emetogenic chemotherapy.
Sussanne Börjeson - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of antiemetic practices for prevention of chemotherapy-induced nausea and vomiting (CINV): results of a European oncology nurse survey
Supportive Care in Cancer, 2019Co-Authors: Pascale Dielenseger, Sussanne Börjeson, Cheryl Vidall, Annie Young, Patrick JahnAbstract:IntroductionPreventing CINV is possible when guideline-recommended Antiemetics are used. Because oncology nurses play a critical role in risk assessment and management of CINV, a survey of European nurses was conducted to evaluate antiemetic practices, assess awareness of and adherence to current guideline recommendations, and explore barriers to adherence.MethodsFrom March 2016 to Feb 2017, 212 oncology nurses in 16 European countries completed a 20-question online survey.ResultsRespondents had 15-year (median) oncology nursing experience, and most (75%) were able to suggest or prescribe Antiemetics. Most (80%) worked in the public not-for-profit hospital setting. Guideline awareness was generally low with nurses most familiar with ASCO (46%) and MASCC/ESMO (40%) guidelines; individual institution guidelines were most commonly used (47%). Key discrepancies between reported antiemetic use and guideline recommendations in the highly emetogenic chemotherapy (HEC) setting were underutilization of the recommended NK_1RA + 5-HT_3RA + steroid combination on day 1 (55%) and high use of 5-HT_3RAs (50%) on days 2–5 when a steroid (63% use) should be used. Metoclopramide use was high in both HEC and moderately emetogenic settings, with ~ 30% and ~ 50% reporting use on day 1 and days 2–5, respectively. The most common reported barrier to use of guideline-recommended agents was physician preference (40%). The most common challenges in managing CINV were “controlling nausea/vomiting in the delayed phase” (64%) and “reducing the impact of CINV on patients’ quality-of-life” (61%).ConclusionsThis survey highlights opportunities to improve utilization of guideline-recommended Antiemetics, thereby optimizing prevention of CINV and QoL for patients receiving emetogenic chemotherapy.
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evaluation of antiemetic practices for prevention of chemotherapy induced nausea and vomiting cinv results of a european oncology nurse survey
Supportive Care in Cancer, 2019Co-Authors: Pascale Dielenseger, Sussanne Börjeson, Cheryl Vidall, Annie Young, Patrick JahnAbstract:Preventing CINV is possible when guideline-recommended Antiemetics are used. Because oncology nurses play a critical role in risk assessment and management of CINV, a survey of European nurses was conducted to evaluate antiemetic practices, assess awareness of and adherence to current guideline recommendations, and explore barriers to adherence. From March 2016 to Feb 2017, 212 oncology nurses in 16 European countries completed a 20-question online survey. Respondents had 15-year (median) oncology nursing experience, and most (75%) were able to suggest or prescribe Antiemetics. Most (80%) worked in the public not-for-profit hospital setting. Guideline awareness was generally low with nurses most familiar with ASCO (46%) and MASCC/ESMO (40%) guidelines; individual institution guidelines were most commonly used (47%). Key discrepancies between reported antiemetic use and guideline recommendations in the highly emetogenic chemotherapy (HEC) setting were underutilization of the recommended NK1RA + 5-HT3RA + steroid combination on day 1 (55%) and high use of 5-HT3RAs (50%) on days 2–5 when a steroid (63% use) should be used. Metoclopramide use was high in both HEC and moderately emetogenic settings, with ~ 30% and ~ 50% reporting use on day 1 and days 2–5, respectively. The most common reported barrier to use of guideline-recommended agents was physician preference (40%). The most common challenges in managing CINV were “controlling nausea/vomiting in the delayed phase” (64%) and “reducing the impact of CINV on patients’ quality-of-life” (61%). This survey highlights opportunities to improve utilization of guideline-recommended Antiemetics, thereby optimizing prevention of CINV and QoL for patients receiving emetogenic chemotherapy.