Awareness of chemotherapy-induced nausea and vomiting and adherence to guidelines: results of a multinational and multicenter survey, part of the THRIVE program.

PURPOSE: Chemotherapy-induced nausea and vomiting (CINV) is a common adverse effect that clearly benefits from prophylactic management. Awareness of CINV and adherence to CINV management guidelines was assessed under a continuing medical education program involving a personal practice assessment (PPA)-THRIVE (Training to Help Reduce CINV ratEs).

METHODS

Forty-six medical oncologists from Canada (n = 21), Brazil (n = 20), and Argentina (n = 5) answered an anonymous survey of their practices during patient consultations. The questionnaire was developed by a group of medical oncologist experts.

RESULTS

The survey included data on 446 patients with multiple cancer types undergoing treatment with highly emetogenic chemotherapy (HEC; 60%) and moderately emetogenic chemotherapy (MEC; 40%). Although 65% of respondents reported using more than one guideline to establish CINV management protocols, discrepancies between respondents' classifications and major guidelines were observed, particularly for newer agents and carboplatin dosing. In addition, 11% of respondents did not discuss personal additional risk factors for CINV with patients. Regarding CINV prophylactic protocol for MEC, 39% of respondents did not include neurokinin 1 receptor antagonist (NK-1 RA) in the regimen for patients with additional risk factors on MEC. The survey also revealed significant variability in the time points adopted for assessing CINV, with 35% of physicians relying solely on spontaneous reports by patients of delayed CINV.

CONCLUSION

There is a pressing need to explore and support initiatives for effective implementation of guidelines and identifying the causes of nonadherence.