Professional educational needs for chemotherapy-induced nausea and vomiting (CINV): multinational survey results from 2,388 health care providers

Abstract

Purpose Because as many as 30% of cancer patients who receive chemotherapy of moderate or high emetogenic potential suffer from chemotherapy-induced nausea and vomiting (CINV), we undertook a multinational survey to identify healthcare providers’ perceived knowledge gaps, barriers, and educational interests relevant to CINV. Methods An Internet-based survey was developed and was electronically disseminated to members of Medscape, an international Internet-based continuing medical education provider. Results A total of 2388 healthcare providers responded to the survey. Although breakthrough nausea and vomiting was the most common CINV-related issue they managed in the preceding year, managing delayed nausea was the most problematic in that time period. Thirty-two percent of healthcare providers delayed or discontinued a patient's chemotherapy because of CINV. Cost of antiemetics, patients’ poor adherence to antiemetic regimens, and healthcare providers’ underestimation of risk for CINV were all barriers to effective management. Healthcare providers expressed a wide range of educational interests, including managing breakthrough CINV, keeping up with novel antiemetic agents, and learning about emerging approaches for CINV prevention/management. Conclusions This survey of healthcare providers uncovered key barriers and educational needs relevant to the management of CINV. The findings from this survey can be used to develop educational initiatives focused on improving the care of cancer patients at risk for or suffering from CINV.

Response

“…We wholeheartedly agree with Tendas et al that education on chemotherapy-induced nausea and vomiting (CINV) in bone marrow transplant (BMT) patients is important and might improve outcomes [1][2][3][4].…”

“…While we did not ask our survey participants if they took care of BMT patients, one could speculate that the 15-22 % who indicated they disagreed with the need for education on this topic were likely not involved with BMT patients [1]. Importantly, in our survey, a full 78 to 85 % of hematology/ oncology physicians and nurses, respectively, indicated they either agreed or strongly agreed that education on the prevention/management of CINV in BMT is warranted.…”

“…

Dear Editor,We wholeheartedly agree with Tendas et al that education on chemotherapy-induced nausea and vomiting (CINV) in bone marrow transplant (BMT) patients is important and might improve outcomes [1][2][3][4].While we did not ask our survey participants if they took care of BMT patients, one could speculate that the 15-22 % who indicated they disagreed with the need for education on this topic were likely not involved with BMT patients [1]. Importantly, in our survey, a full 78 to 85 % of hematology/ oncology physicians and nurses, respectively, indicated they either agreed or strongly agreed that education on the prevention/management of CINV in BMT is warranted.

That CINV occurs in patients undergoing BMT is reason enough to offer further education on this topic to health-care providers.

…”

Patterns of antiemetic prophylaxis for chemotherapy-induced nausea and vomiting in China

“…Worldwide rates of treatment for delayed CINV, therefore, seem to exhibit substantial variability. Surveys of health care providers have revealed that cost-and patient-related issues are frequently cited as barriers to treating CINV (24,25). In those countries with low rates of prophylactic therapy, these factors should be considered if or when programs are implemented to increase the use of antiemetic medications.…”

Hydration Requirements with Emetogenic Chemotherapy: Granisetron Extended-Release Subcutaneous Versus Palonosetron

“…Poorly controlled chemotherapy-induced nausea and vomiting (CINV) negatively affects patient health, quality of life and chemotherapy compliance [1][2][3][4][5][6][7], and is associated with increased resource utilization and healthcare costs [7][8][9][10]. Despite comprehensive antiemetic treatment guidelines [11][12][13][14], there is still an unmet clinical need to improve the prevention of CINV.…”