Abstract | BACKGROUND: METHODS: The data source was the Global Oncology Monitor (Ipsos Healthcare). Geographically representative physicians from France, Germany, Italy, Spain, and the U.K. were screened for treatment involvement and number of patients treated per month. Patients' data from January to December 2018 were collected from medical charts and extrapolated on the basis of the total number of physicians who prescribe chemotherapy. The emetic risk of chemotherapy was classified per MASCC/ESMO guidelines. RESULTS: Data from 45,324 chemotherapy-treated patients were collected, representing a total extrapolated prevalence of 1,394,848 chemotherapy treatments included in the analysis. NK1 RAs were used in 45%, 42%, and 19% of patients receiving cisplatin-, AC-, and carboplatin-based chemotherapy, respectively; 18%, 24%, and 7% received the guideline-recommended NK1 RA-5-HT3 RA- dexamethasone combination; no antiemetics were prescribed for 12% of the treatments. Often, physicians' perception of the emetic risk of chemotherapy did not follow MASCC/ESMO guideline classification. CONCLUSION: Low adherence to antiemetic guidelines was revealed in clinical practice in five European countries, with 15% of all HEC-/ carboplatin-based treatments receiving guideline-recommended NK1 RA-5-HT3 RA- dexamethasone prophylaxis and 12% of them receiving no antiemetics. New strategies for improving guideline adherence are urgently needed. IMPLICATIONS FOR PRACTICE: Despite recent advances in antiemetic therapy, a substantial proportion of patients experience nausea and vomiting associated with chemotherapy in daily clinical practice. Antiemetic guidelines aim at prevention of chemotherapy-induced nausea and vomiting (CINV), and guideline-consistent antiemetic therapy can effectively prevent vomiting and, to a lesser extent, nausea in most patients with cancer. This study reports low adherence to antiemetic guidelines in the highly emetogenic chemotherapy setting in daily clinical practice across five European countries. Opportunity exists to increase adherence to antiemetic guideline recommendations. Implementation of strategies to facilitate guideline adherence can potentially improve CINV control.
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Authors | Matti Aapro, Florian Scotté, Yolanda Escobar, Luigi Celio, Richard Berman, Alessandra Franceschetti, Danielle Bell, Karin Jordan |
Journal | The oncologist
(Oncologist)
Vol. 26
Issue 6
Pg. e1073-e1082
(06 2021)
ISSN: 1549-490X [Electronic] England |
PMID | 33555084
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2021 AlphaMed Press. |
Chemical References |
- Antibiotics, Antineoplastic
- Antiemetics
- Antineoplastic Agents
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Topics |
- Antibiotics, Antineoplastic
(therapeutic use)
- Antiemetics
(therapeutic use)
- Antineoplastic Agents
(adverse effects)
- Europe
- France
- Germany
- Guideline Adherence
- Humans
- Italy
- Nausea
(chemically induced, drug therapy, prevention & control)
- Spain
- Vomiting
(chemically induced, drug therapy, prevention & control)
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