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Adherence to ESMO clinical recommendations for prophylaxis of chemotherapy-induced nausea and vomiting

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Abstract

Background

We assessed adherence to the European Society of Medical Oncology (ESMO)/Multinational Association of Supportive Care in Cancer recommendations for prophylaxis of chemotherapy-induced nausea and vomiting (CINV) at our institution.

Patients and methods

The charts of 299 patients starting a new chemotherapy between November 2008 and April 2009 were reviewed. Baseline characteristics and prophylaxis of CINV during the first cycle were recorded, and adherence to ESMO recommendations was determined. Chi-square tests and logistic regression were used to test for predictors of adherence.

Results

Prophylaxis of acute CINV was not adherent in 39% of the patients: 39 of 54 patients with low emetogenic chemotherapy had a serotonin antagonist, and 24 of 100 with moderately emetogenic therapy had a neurokinin antagonist. Nevertheless, 71% of the patients treated with highly emetogenic therapy received the guideline-specified prescription. Prophylaxis of delayed CINV was not adherent in 89% of the patients: 101 of 125 patients with highly or moderately emetogenic single-day chemotherapy received a serotonin antagonist. Male gender (odds ratio (OR) 0.484, 95% confidence interval (CI) 0.291–0.806; P = 0.005) and hematologic neoplasia (OR 2.151, 95% CI 1.19–3.887; P = 0.011) were independent predictors of non-adherence. Age (OR 0.981, 95% CI 0.964–0.998; P = 0.029) and inpatient treatment (OR 0.457, 95% CI 0.25–0.836; P = 0.011) indicated a lower risk of non-adherence.

Conclusion

Contrary to older studies reporting frequent omissions of corticosteroids, the current study demonstrated significant overuse of serotonin antagonists for prophylaxis of delayed CINV.

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Acknowledgments

The authors would like to thank Daniel Ratschiller for database management. An acknowledgment should also go to Jürg Bernhard for his comments.

Potential conflicts of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Medical Oncology, University Hospital Bern, 3010, Bern, Switzerland

    Henning Burmeister, Stefan Aebi, Cristina Studer, Martin F. Fey & Oliver Gautschi

Authors
  1. Henning Burmeister
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  2. Stefan Aebi
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  3. Cristina Studer
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  4. Martin F. Fey
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  5. Oliver Gautschi
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Corresponding author

Correspondence to Henning Burmeister.

Appendix

Appendix

Table 3 Adherence in patients with highly emetogenic chemotherapy
Full size table
Table 4 Adherence in patients with moderately emetogenic chemotherapy
Full size table
Table 5 Adherence in patients with low emetogenic chemotherapy
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Table 6 Non-compliance subdivided into undertreated vs. overtreated
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Burmeister, H., Aebi, S., Studer, C. et al. Adherence to ESMO clinical recommendations for prophylaxis of chemotherapy-induced nausea and vomiting. Support Care Cancer 20, 141–147 (2012). https://doi.org/10.1007/s00520-010-1079-3

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  • DOI: https://doi.org/10.1007/s00520-010-1079-3

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