Guideline concordant care for prevention of acute chemotherapy-induced nausea and vomiting in children, adolescents, and young adults

Beauchemin, Melissa; Sung, Lillian; Hershman, Dawn L.; Weng, Chunhua; Dupuis, L. Lee; Schnall, Rebecca

doi:10.1007/s00520-020-05310-6

Cited by 22 publications

(20 citation statements)

References 41 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%

“…[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. 8 Bun et al found agreement rates ranging from 21.5% to 52%, depending on the degree of emetogenicity of the protocol in use and on the age range of the patients.…”

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%

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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“…Approximately 45–61% of cancer patients suffer from chemotherapy-induced nausea and vomiting (CINV). In antiemetic prophylaxis during chemotherapy, the following are used: (i) drugs from the group of 5-HT 3 receptor antagonists—ondansetron, granisetron, tropisetron, dolasetron, palonosetron; (ii) drugs from the group of neurokinin-1 receptor antagonists—aprepitant; (iii) corticosteroids—the most commonly recommended dexamethasone or methylprednisolone; and (iv) complementary drugs: dopamine receptor antagonists (metoclopramide), phenothiazine derivatives (chlorpromazine), antihistamines, and butyrophenone derivatives (haloperidol and droperidol) [ 112 ]. The guidelines propose the use of antiemetic drugs in monotherapy or according to a schedule of two-to-three drugs, depending on the degree of risk of nausea and vomiting and the individual sensitivity of the patient.…”

Section: Pharmacological Applicationmentioning

confidence: 99%

Cannabis sativa L. as a Natural Drug Meeting the Criteria of a Multitarget Approach to Treatment

Stasiłowicz

Tomala

Podolak

et al. 2021

IJMS

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Cannabis sativa L. turned out to be a valuable source of chemical compounds of various structures, showing pharmacological activity. The most important groups of compounds include phytocannabinoids and terpenes. The pharmacological activity of Cannabis (in epilepsy, sclerosis multiplex (SM), vomiting and nausea, pain, appetite loss, inflammatory bowel diseases (IBDs), Parkinson’s disease, Tourette’s syndrome, schizophrenia, glaucoma, and coronavirus disease 2019 (COVID-19)), which has been proven so far, results from the affinity of these compounds predominantly for the receptors of the endocannabinoid system (the cannabinoid receptor type 1 (CB1), type two (CB2), and the G protein-coupled receptor 55 (GPR55)) but, also, for peroxisome proliferator-activated receptor (PPAR), glycine receptors, serotonin receptors (5-HT), transient receptor potential channels (TRP), and GPR, opioid receptors. The synergism of action of phytochemicals present in Cannabis sp. raw material is also expressed in their increased bioavailability and penetration through the blood–brain barrier. This review provides an overview of phytochemistry and pharmacology of compounds present in Cannabis extracts in the context of the current knowledge about their synergistic actions and the implications of clinical use in the treatment of selected diseases.

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“…25,26 In fact, we recently reported that patients receiving emetogenic chemotherapy with commercial insurance were significantly more likely to receive guidelineconcordant antiemetic prophylaxis compared with those with Medicaid (odds ratio [OR]: 2.4; 95% confidence interval [95% CI]: 1.0-4.8). 19 All available EHR data from the first clinical encounter for HEC were included for each eligible patient.…”

Section: Samplementioning

confidence: 99%

Data Quality of Chemotherapy-Induced Nausea and Vomiting Documentation

et al. 2021

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Objective The objective of the study was to characterize the completeness and concordance of the electronic health record (EHR) documentation of cancer symptoms among multidisciplinary health care professionals. Methods We examined the EHRs of children, adolescents, and young adults who received highly emetogenic chemotherapy and characterized the completeness and concordance of chemotherapy-induced nausea and vomiting (CINV) documentation by clinician type and by the International Classification of Diseases 10th Revision (ICD-10) coding choice. Results The EHRs of 127 patients, comprising 870 patient notes, were abstracted and reviewed. A CINV assessment was documented by prescribers in 75% of patients, and by nurses in 58% of patients. Of the 60 encounters where both prescribers and nurses documented, 72% agreed on the presence/absence of CINV. Conclusion Most patients receiving highly emetogenic chemotherapy had a documented assessment of CINV; however, many had incomplete or discordant documentation of CINV from different providers by role, implying the importance of incorporating pragmatic knowledge of EHR documentation patterns among multidisciplinary health professionals for EHR phenotyping and clinical decision support systems directed toward cancer-related symptom management.

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Guideline concordant care for prevention of acute chemotherapy-induced nausea and vomiting in children, adolescents, and young adults

Cited by 22 publications

References 41 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

Cannabis sativa L. as a Natural Drug Meeting the Criteria of a Multitarget Approach to Treatment

Data Quality of Chemotherapy-Induced Nausea and Vomiting Documentation

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