How Much Are Patients Willing to Pay to Avoid Postoperative Nausea and Vomiting?

Gan, Tong J.; Sloan, Frank A.; Dear, GdeL; El-Moalem, Habib; Lubarsky, David A.

doi:10.1213/00000539-200102000-00022

Cited by 279 publications

(90 citation statements)

References 16 publications

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“…It is remarkable that patients were willing to spend 20% of the money they have for free disposition per month. This result (median amount of money: £84) is in good agreement with recent results where patients stated that they would pay 56-100 US$ for an effective anti-emetic [23].…”

Section: Discussionsupporting

confidence: 91%

Impact of a multimodal anti‐emetic prophylaxis on patient satisfaction in high‐risk patients for postoperative nausea and vomiting

et al. 2002

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Postoperative nausea and vomiting (PONV) are frequent and unpleasant symptoms. This prospective study aimed to assess the efficacy of a multimodal approach to prevent PONV, and patient satisfaction using the willingness-to-pay method. Two validated risk scores were applied to forecast the individual risk for PONV in 900 consecutive patients of whom 108 were identified as high-risk patients (predicted risk: 79-87%). High-risk patients received multimodal anti-emetic prophylaxis: total intravenous anaesthesia with propofol, high fractional inspired oxygen (80%), omission of nitrous oxide, dexamethasone 8 mg, haloperidol 10 lg.kg, and tropisetron 2 mg. Of the remaining patients with low or moderate risk for PONV, a random sample of 71 females received balanced propofol-desflurane anaesthesia without prophylactic anti-emetics. All patients were interviewed 2 and 24 h after surgery for occurrence of nausea and vomiting. Patient satisfaction was measured using the willingness-to-pay method. The incidence of PONV (95%-confidence interval) in the control-group was 41% (29-51%), slightly lower than predicted by the risk scores (53-57%). The multimodal anti-emetic approach reduced the predicted risk (79-87%) in the high risk-group to 7% (3-14%). This was associated with a high willingness-to-pay median (25th ⁄ 75th percentile) of £84 (£33-184) in the multimodal anti-emetic grouped compared to £14 (£4-30) in the control group. A multimodal anti-emetic approach can considerably reduce the incidence of PONV in high-risk patients and is associated with a high patient satisfaction as measured by the willingness-to-pay method.

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Section: Discussionsupporting

confidence: 91%

Impact of a multimodal anti‐emetic prophylaxis on patient satisfaction in high‐risk patients for postoperative nausea and vomiting

et al. 2002

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“…30 The NNT (95% CI) to stay completely free from nausea was 8 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) during the first six hours postoperatively and 6 (3-33) for the period from zero to 48 hr. For vomiting, the NNT (95% CI) was 7 (4-50) and 5 (3)(4)(5)(6)(7)(8) for the early and the 48-hr period respectively. 30 The recommended dose for cyclizine is 50 mg (IIIA).…”

Section: Other Older Generation Antiemeticsmentioning

confidence: 99%

“…5 Gan and colleagues also reported that surgical patients were willing to pay up to US $100, at their own expense, to avoid PONV. 6 In this article, we will present evidence regarding the prophylaxis and treatment of PONV based on the available literature using data from randomized controlled trials, systematic reviews, logistic regression analyses, and expert opinion. We will adopt the rating scale used by a consensus panel of experts who generated guidelines for the management of PONV (Table I).…”

mentioning

confidence: 99%

Evidence-based management of postoperative nausea and vomiting: a review

Habib

Gan

2004

Can J Anesth/J Can Anesth

Self Cite

196

106

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P Pu ur rp po os se e: : To provide evidence-based guidelines for the prophylaxis and treatment of postoperative nausea and vomiting (PONV).S So ou ur rc ce e: : Literature from randomized controlled trials, systematic reviews, logistic regression analyses and expert opinion in the management of PONV.P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : The etiology of PONV is multifactorial. Patient, anesthesia, and surgery related risk factors have been identified. Universal PONV prophylaxis is not cost-effective. Identification of patients at high-risk of PONV allows targeting prophylaxis to those who will benefit most from it. No prophylaxis is needed for patients at low risk for PONV. For patients at moderate risk for PONV, prophylaxis using a single antiemetic or a combination of two agents should be considered. Double and triple antiemetic combinations should be considered for patients at high risk for PONV. Furthermore, a multimodal approach should be adopted incorporating steps to keep the baseline risk of PONV low. The optimum cost-effective approach to the management of PONV will differ between an ambulatory centre and an inpatient hospital setting. For the treatment of established PONV in patients who failed prophylaxis, patients should not receive a repeat dose of the prophylactic antiemetic. Rather, a drug acting at a different receptor should be used. Beyond six hours after surgery, patients can be treated with any of the agents used for prophylaxis, except dexamethasone and transdermal scopolamine.C Co on nc cl lu us si io on n: : PONV are common after anesthesia and surgery. We provided evidence-based guidelines for the management of this problem based on the available literature. Objectif : Énoncer des lignes de conduite fondées sur des données probantes pour la prévention et le traitement des nausées et des vomissements postopératoires (NVPO). Source : Les publications d'essais contrôlés et randomisés, les études méthodiques, les analyses de régression logistique et l'opinion d'experts sur le traitement des NVPO. Constatations principales : L'origine des NVPO est multifactorielle. Les facteurs de risque reliés au patient, à l'anesthésie et au type de chirurgie sont connus. La prévention universelle des NVPO n'est pas rentable. L'identification des patients à haut risque de NVPO permet

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“…This can delay discharge and result in unplanned overnight hospital admission. In fact, its contribution to patient dissatisfaction is such that over 70% of patients considered avoidance of PONV to be very important 4 . Anxiety increases the incidence of PONV.…”

Section: Discussionmentioning

confidence: 99%

Comparison of ondansetron & dexamethasone in prevention of postoperative nausea & vomiting in laparoscopic surgery

Agravat

Srinivasa

Ingle

et al. 2014

Int Jour of Biomed Res

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How Much Are Patients Willing to Pay to Avoid Postoperative Nausea and Vomiting?

Cited by 279 publications

References 16 publications

Impact of a multimodal anti‐emetic prophylaxis on patient satisfaction in high‐risk patients for postoperative nausea and vomiting

Impact of a multimodal anti‐emetic prophylaxis on patient satisfaction in high‐risk patients for postoperative nausea and vomiting

Evidence-based management of postoperative nausea and vomiting: a review

Comparison of ondansetron & dexamethasone in prevention of postoperative nausea & vomiting in laparoscopic surgery

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