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[Analysis of the effectiveness of an antiemetic protocol used in an oncology division].

AbstractOBJECTIVE:
To analyse the effectiveness of an antiemetic protocol in patients receiving chemotherapy treatment.
METHOD:
Prospective study in patients with solid tumours receiving chemotherapy in an oncology day hospital between January 2006 and 2007. We conducted a literature review and an evaluation of the recommendations of different clinical practice guidelines. The emetogenic potential was calculated according to the Hesketh level (HL), and the antiemetic premedication was determined for each regimen. We evaluated the effectiveness of an antiemetic protocol by using a survey as a method for measuring emetic episodes and nausea in the acute and delayed phases.
RESULTS:
172 patients completed the survey. 13.4% vomited in the acute phase and 16.9% in the delayed phase; the median number of times was 2 (1-8) and 1 (1-5) for each respective phase. With treatment regimens classed as HL 4-5, 18.5% experienced vomiting in the acute phase and 20.2% in the delayed phase, with 46% experiencing nausea in the acute phase and 38.4% in the delayed phase. Control of vomiting in patients with treatment regimens classed as HL 1-3 was 100% in acute phase and 91.7% in the delayed phase; nausea was reported by 27% in the acute phase and 31% in the delayed phase. The factors that contributed the most to the presence of vomiting and nausea were the emetogenic potential of the treatment regimen (p<0.05), vomiting in the previous cycle (p<0.05) and age younger than 50 years (p<0.002).
DISCUSSION:
The proposed antiemetic protocol is effective for controlling vomiting in chemotherapy regimens with an HL of 1-3. For highly emetogenic regimens, the antiemetic protocol is also effective, but protection is not complete. This protocol seems less effective for controlling nausea, although this is a subjective symptom which is difficult to assess and not routinely measured in clinical trials.
AuthorsM J Huertas-Fernández, M J Martínez-Bautista, I Sánchez-Martínez, M Zarzuela-Ramírez, J M Baena-Cañada
JournalFarmacia hospitalaria : organo oficial de expresion cientifica de la Sociedad Espanola de Farmacia Hospitalaria (Farm Hosp) 2010 May-Jun Vol. 34 Issue 3 Pg. 125-38 ISSN: 1130-6343 [Print] Spain
Vernacular TitleAnálisis de la efectividad de un protocolo de antiemesis implantado en la Unidad de Oncología.
PMID20206564 (Publication Type: Clinical Trial, English Abstract, Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2009 SEFH. Published by Elsevier Espana. All rights reserved.
Chemical References
  • Antiemetics
  • Antineoplastic Agents
  • Ondansetron
  • Dexamethasone
Topics
  • Adult
  • Age Factors
  • Antiemetics (administration & dosage, therapeutic use)
  • Antineoplastic Agents (adverse effects)
  • Breast Neoplasms (complications, drug therapy)
  • Clinical Protocols
  • Dexamethasone (administration & dosage, therapeutic use)
  • Drug Administration Schedule
  • Female
  • Gastrointestinal Neoplasms (complications, drug therapy)
  • Humans
  • Lung Neoplasms (complications, drug therapy)
  • Male
  • Middle Aged
  • Nausea (chemically induced, drug therapy, etiology, prevention & control)
  • Neoplasms (complications, drug therapy)
  • Oncology Service, Hospital
  • Ondansetron (administration & dosage, therapeutic use)
  • Patient Satisfaction
  • Practice Guidelines as Topic
  • Premedication
  • Prospective Studies

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