Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital

Objectives: To assess if the antiemetic prophylaxis prescribed to patients exposed to chemotherapy is following the Antiemesis guideline published by the National Comprehensive Cancer Network (NCCN) version 3.2018. Methods: A medication review was performed, considering antiemetic´s prescriptions o...

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Autores principales:	Gustavo M. LÁZARO, Juliane CARLOTTO, Inajara ROTTA
Formato:	article
Lenguaje:	EN PT
Publicado:	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde 2020
Materias:	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/8061310e3b2b4e5f9438b3340acb20fb
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spelling	oai:doaj.org-article:8061310e3b2b4e5f9438b3340acb20fb2021-11-28T02:44:40ZAdherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital10.30968/rbfhss.2020.113.04872179-59242316-7750https://doaj.org/article/8061310e3b2b4e5f9438b3340acb20fb2020-09-01T00:00:00Zhttps://www.rbfhss.org.br/sbrafh/article/view/487https://doaj.org/toc/2179-5924https://doaj.org/toc/2316-7750 Objectives: To assess if the antiemetic prophylaxis prescribed to patients exposed to chemotherapy is following the Antiemesis guideline published by the National Comprehensive Cancer Network (NCCN) version 3.2018. Methods: A medication review was performed, considering antiemetic´s prescriptions of adult patients under treatment with moderate and high emetogenic potential antineoplastic agents, assisted on an outpatient basis in a tertiary public hospital, from May to September 2019. The information contained in the prescriptions was compared with the guideline recommendations in relation to the selection of the therapeutic class of the antiemetic, dose, route of administration, dosage regimen and duration of treatment, with the prophylaxis expected for the acute and delayed phases being evaluated. Results: Were included 87 patients, 38 and 49 of whom used chemotherapy drugs with high and moderate emetogenic potential, respectively. In the prescriptions containing highly emetogenic chemotherapeutic agents, the antiemetic therapy recommended for acute phase prophylaxis was incorrectly prescribed for 9 patients (23.7%), and the problem encountered was dexamethasone underdose (16.7%). In the delayed phase, problems were identified in the prescriptions of 35 patients (92.1%), including the prescription of inappropriate medication (57.4%), since the prescription contained ondansetron, not foreseen by the guideline at this stage, and the need for dexamethasone as an additional drug (18.5%). For 22 patients (44.9%) exposed to moderately emetogenic antineoplastic agents, the acute regimen was incorrectly prescribed, and the main problems identified were dexamethasone overdose (21.2%) and the need for dexamethasone as an additional drug (5.0%). Delayed antiemetic prophylaxis was incorrectly prescribed for 45 of them (91.8%), with ondansetron treatment duration longer than recommended (26.2%), need for dexamethasone or ondansetron as an additional medication (23.7%) and therapeutic duplicity (12.5%) the problems encountered. Conclusion: It is suggested the implementation of strategies aimed at increasing adherence to the guideline’s recommendations by the prescribers, as well as access to medicines considered essential. Gustavo M. LÁZAROJuliane CARLOTTO Inajara ROTTASociedade Brasileira de Farmácia Hospitalar e Serviços de SaúdearticlePublic aspects of medicineRA1-1270Pharmacy and materia medicaRS1-441Therapeutics. PharmacologyRM1-950ENPTRevista Brasileira de Farmácia Hospitalar e Serviços de Saúde, Vol 11, Iss 3 (2020)
institution	DOAJ
collection	DOAJ
language	EN PT
topic	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
spellingShingle	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950 Gustavo M. LÁZARO Juliane CARLOTTO Inajara ROTTA Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital
description	Objectives: To assess if the antiemetic prophylaxis prescribed to patients exposed to chemotherapy is following the Antiemesis guideline published by the National Comprehensive Cancer Network (NCCN) version 3.2018. Methods: A medication review was performed, considering antiemetic´s prescriptions of adult patients under treatment with moderate and high emetogenic potential antineoplastic agents, assisted on an outpatient basis in a tertiary public hospital, from May to September 2019. The information contained in the prescriptions was compared with the guideline recommendations in relation to the selection of the therapeutic class of the antiemetic, dose, route of administration, dosage regimen and duration of treatment, with the prophylaxis expected for the acute and delayed phases being evaluated. Results: Were included 87 patients, 38 and 49 of whom used chemotherapy drugs with high and moderate emetogenic potential, respectively. In the prescriptions containing highly emetogenic chemotherapeutic agents, the antiemetic therapy recommended for acute phase prophylaxis was incorrectly prescribed for 9 patients (23.7%), and the problem encountered was dexamethasone underdose (16.7%). In the delayed phase, problems were identified in the prescriptions of 35 patients (92.1%), including the prescription of inappropriate medication (57.4%), since the prescription contained ondansetron, not foreseen by the guideline at this stage, and the need for dexamethasone as an additional drug (18.5%). For 22 patients (44.9%) exposed to moderately emetogenic antineoplastic agents, the acute regimen was incorrectly prescribed, and the main problems identified were dexamethasone overdose (21.2%) and the need for dexamethasone as an additional drug (5.0%). Delayed antiemetic prophylaxis was incorrectly prescribed for 45 of them (91.8%), with ondansetron treatment duration longer than recommended (26.2%), need for dexamethasone or ondansetron as an additional medication (23.7%) and therapeutic duplicity (12.5%) the problems encountered. Conclusion: It is suggested the implementation of strategies aimed at increasing adherence to the guideline’s recommendations by the prescribers, as well as access to medicines considered essential.
format	article
author	Gustavo M. LÁZARO Juliane CARLOTTO Inajara ROTTA
author_facet	Gustavo M. LÁZARO Juliane CARLOTTO Inajara ROTTA
author_sort	Gustavo M. LÁZARO
title	Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital
title_short	Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital
title_full	Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital
title_fullStr	Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital
title_full_unstemmed	Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital
title_sort	adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital
publisher	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde
publishDate	2020
url	https://doaj.org/article/8061310e3b2b4e5f9438b3340acb20fb
work_keys_str_mv	AT gustavomlazaro adherencetoguidelinesformanagementofchemotherapyinducednauseaandvomitinginatertiarypublichospital AT julianecarlotto adherencetoguidelinesformanagementofchemotherapyinducednauseaandvomitinginatertiarypublichospital AT inajararotta adherencetoguidelinesformanagementofchemotherapyinducednauseaandvomitinginatertiarypublichospital
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Adherence to guidelines for management of chemotherapy-induced nausea and vomiting in a tertiary public hospital

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