Cohort study of consistency between the compliance with guidelines for chemotherapy-induced nausea and vomiting and patient outcome

BMC Clinical Pharmacology

Hiroyuki Shibata²  Masatomo Miura¹  Kazunori Otsuka²  Naomi Shindo²  Manabu Shoji¹  Masahiro Inoue² 

[1] Department of Pharmacy, Akita University, Akita, Japan;Division of Chemotherapy for Outpatient, Akita University, Akita, Japan

关键词: Emetogenicity;    Guidelines;    Chemotherapy-induced nausea and vomiting;   

Others  :  1145164
DOI  :  10.1186/s40360-015-0005-1

 received in 2014-10-09, accepted in 2015-03-12,  发布年份 2015

【 摘 要 】

Background

Chemotherapy-induced nausea and vomiting is one of the most influential factors that affect patient quality of life; thus, preventing this adverse event could lead to better patient outcome. Standard preventive guidelines for antiemetic treatment have already been established based on the emetogenicity of chemotherapeutic agents. It is important that compliance with in-house guidelines and their effect on patient outcome is monitored.

Methods

In 3 years since the Akita university hospital antiemetic guidelines were outlined, we assessed the incidence of chemotherapy-induced nausea and vomiting using the antiemesis tool of the Multinational Association of Supportive Care in Cancer. Compliance of the guidelines was extracted from the hospital clinical record, and the chemotherapy-induced nausea and vomiting was examined by the patient reported outcome.

Results

Seventy-three patients answered the questionnaire. The overall compliance rate with the guidelines for early nausea and vomiting was 98.6% and with the delayed nausea and vomiting was 87.7%. The complete response rate for the early and delayed chemotherapy-induced nausea and vomiting was 77.8% and 73.8%, respectively. The overall relative risk of early nausea and vomiting was 0.22 (P < 0.05), whereas the relative risk for delayed nausea and vomiting was 2.09 (P < 0.05). Breakthrough vomiting was observed in 3 cases in the low-risk group only. These data suggest that delayed nausea and vomiting is difficult to prevent, particularly in the low-risk group. Further, it seems that the individual sensitivity for emetogenicity might differ among patients.

Conclusions

In addition to standard prevention guidelines based on emetogenicity, individual care based on patient reports should be considered for the complete prevention of chemotherapy-induced nausea and vomiting.

【 授权许可】

   
2015 Inoue et al.; licensee BioMed Central.

【 图 表 】

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