Abunahlah, N., Sancar, M., Dane, F., Özyavuz, M., & Özyavuz, M. . (2016). Impact of adherence to antiemetic guidelines on the incidence of chemotherapy-induced nausea and vomiting and quality of life. International Journal of Clinical Pharmacy, 38, 1464–1476. 

To evaluate how adherence to Multinational Association of Supportive Care in Cancer/European Society for Medical Oncology (MASCC/ESMO) 2014 guidelines affect chemotherapy-induced nausea and vomiting (CINV) and quality of life in chemotherapy-naïve patients

The chemotherapy regimens of chemotherapy-naïve participants were assessed to determine which MASCC/ESMO 2014 guideline was appropriate for their antiemetic regimen. The research team then evaluated the antiemetic regimen prescribed and compared it to the MASCC/ESMO 2014 guideline recommended for adherence or non-adherence.

• N = 100   
• MEDIAN AGE = 53 years
• MALES: 48%, FEMALES: 52%
• CURRENT TREATMENT: Chemotherapy
• KEY DISEASE CHARACTERISTICS: Established malignancy
• OTHER KEY SAMPLE CHARACTERISTICS: Patients who were chemotherapy naïve or who received low emetogenic chemotherapy

• SITE: Single site   
• SETTING TYPE: Inpatient    
• LOCATION: Marmara University Pendik Training and Research Hospital in Turkey

PHASE OF CARE: Active antitumor treatment

Prospective, observational, longitudinal

• Daily diary of episodes of emesis, nausea severity (seven-item Likert-type scale), and rescue medications for five days
• Modified Turkish version of the Functional Living Index-Emesis (FLI-E) questionnaire to record quality of life before and after chemotherapy
• Side-effects questionnaire to record existence and severity of side effects

Guideline nonadherence was most often related to overprescription, underprescription, and inappropriate dose or inappropriate prescription. Patients who had antiemetic regimens adherent to the MASCC/ESMO 2014 guidelines had significantly higher complete control of nausea (no emetic episodes, rescue therapy, or nausea) and fewer reported side effects compared to the nonadherent group. Physician compliance with the antiemetics guidelines was observed during the acute phase of CINV, not in the delayed phase.

Patients with antiemetic regimens that adhered to MASCC/ESMO 2014 guidelines reported improved control over CINV and enhanced quality of life related to the reduction of side effects.

• Risk of bias (no control group)
• Risk of bias (no blinding)
• Risk of bias (no random assignment)
• Generalizability of the results to other hospitals

When determining an antiemetic regimen for patients receiving chemotherapy, healthcare professionals should adhere to antiemetic guidelines.