Assessment of adherence to the guidelines for the management of nausea and vomiting induced by chemotherapy

• Published in: Einstein (São Paulo, Brazil) Brazil), 2015-04, Vol.13 (2), p.221-225
• Main Authors: França, Monique Sedlmaier, Usón Junior, Pedro Luiz Serrano, Antunes, Yuri Philippe Pimentel Vieira, Prado, Bernard Lobato, Donnarumma, Carlos del Cistia, Mutão, Taciana Sousa, Rodrigues, Heloisa Veasey, Giglio, Auro del
• Format: Article
• Language: English
• Subjects: Adesão a diretivas antecipadas; Adult; Aged; Aged, 80 and over; Antiemetics - adverse effects; Antiemetics - therapeutic use; Antieméticos; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Breast Neoplasms - drug therapy; Cancer Care Facilities; Carcinoma, Non-Small-Cell Lung - drug therapy; Female; Guideline Adherence; Humans; Inappropriate Prescribing - adverse effects; Lung Neoplasms - drug therapy; Lymphoma, Non-Hodgkin - drug therapy; Male; Medical Records; MEDICINE, GENERAL & INTERNAL; Middle Aged; Nausea - chemically induced; Nausea - prevention & control; Náusea/induzido quimicamente; Original; Protocolos clínicos; Quimioterapia/efeitos adversos; Retrospective Studies; Vomiting - chemically induced; Vomiting - prevention & control; Vômito/induzido quimicamente; Young Adult
• ISSN: 1679-4508; 2317-6385; 2317-6385; 1679-4508
• DOI: 10.1590/S1679-45082015AO3097

To assess adherence of the prescribing physicians in a private cancer care center to the American Society of Clinical Oncology guideline for antiemetic prophylaxis, in the first cycle of antineoplastic chemotherapy. A total of 139 chemotherapy regimens, of 105 patients, were evaluated retrospectively from 2011 to 2013. We observed 78% of non-adherence to the guideline rate. The main disagreements with the directive were the prescription of higher doses of dexamethasone and excessive use of 5-HT3 antagonist for low risk emetogenic chemotherapy regimens. On univariate analysis, hematological malignancies (p=0.005), the use of two or more chemotherapy (p=0.05) and high emetogenic risk regimes (p=0.012) were factors statistically associated with greater adherence to guidelines. Treatment based on paclitaxel was the only significant risk factor for non-adherence (p=0.02). By multivariate analysis, the chemotherapy of high emetogenic risk most correlated with adherence to guideline (p=0.05). We concluded that the adherence to guidelines is greater if the chemotherapy regime has high emetogenic risk. Educational efforts should focus more intensely on the management of chemotherapy regimens with low and moderate emetogenic potential. Perhaps the development of a computer generated reminder may improve the adherence to guidelines.