Evluation of Preventing Regimens Used for Chemotherapy Induced Nausea and Vomiting

Background and Nausea and vomiting are amongst annoying side effects of chemotherapy in cancer treatment. Appropriate use of medications is important for prevention of chemotherapy-induced nausea and vomiting (CINV). In this regard, several guidelines have been proposed. The aim of this study was to investigate the adherence with National Comprehensive Cancer Network (NCCN) guidelines for control of CINV in Ramsar Emam Sajjad Hospital.
This concurrent observational study was carried out in 100 patients with cancer who were receiving either in-patient or outpatient chemotherapy. Relevant patients’ demographic data, chemotherapy regimens and antiemetics were collected. NCCN guideline version 2013 was used as criterion for appropriate treatment.
The mean age of patients was 55.72 ±16.67 years old in male and 50.75 ±13.52 years old in female. The most common types of cancers were breast (25%), colon (21%) and gastric (12%). The rate of adherence to the antiemetic NCCN guidelines according to the type of drug and dosage of prescriptions were 77% and 6%, respectively. The guidelines were fully executed only in 5% of the patients. Non-adherence was mostly due to the lack of aprepitant and failure to comply in doses.
This study demonstrated that in most cases the NCCN guidelines were not implemented. High cost of drug supply is believed to be a major cause of non-compliance with aprepitant usage.