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Evaluation of antiemetic practices for prevention of chemotherapy-induced nausea and vomiting (CINV): results of a European oncology nurse survey

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Abstract

Introduction

Preventing CINV is possible when guideline-recommended antiemetics are used. Because oncology nurses play a critical role in risk assessment and management of CINV, a survey of European nurses was conducted to evaluate antiemetic practices, assess awareness of and adherence to current guideline recommendations, and explore barriers to adherence.

Methods

From March 2016 to Feb 2017, 212 oncology nurses in 16 European countries completed a 20-question online survey.

Results

Respondents had 15-year (median) oncology nursing experience, and most (75%) were able to suggest or prescribe antiemetics. Most (80%) worked in the public not-for-profit hospital setting. Guideline awareness was generally low with nurses most familiar with ASCO (46%) and MASCC/ESMO (40%) guidelines; individual institution guidelines were most commonly used (47%). Key discrepancies between reported antiemetic use and guideline recommendations in the highly emetogenic chemotherapy (HEC) setting were underutilization of the recommended NK1RA + 5-HT3RA + steroid combination on day 1 (55%) and high use of 5-HT3RAs (50%) on days 2–5 when a steroid (63% use) should be used. Metoclopramide use was high in both HEC and moderately emetogenic settings, with ~ 30% and ~ 50% reporting use on day 1 and days 2–5, respectively. The most common reported barrier to use of guideline-recommended agents was physician preference (40%). The most common challenges in managing CINV were “controlling nausea/vomiting in the delayed phase” (64%) and “reducing the impact of CINV on patients’ quality-of-life” (61%).

Conclusions

This survey highlights opportunities to improve utilization of guideline-recommended antiemetics, thereby optimizing prevention of CINV and QoL for patients receiving emetogenic chemotherapy.

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Acknowledgements

Cogora, an independent European market access and customer intelligence agency, managed the conduct of the survey and summarized the findings. Editorial and medical writing assistance was provided by Jennifer Vanden Burgt, an independent medical writer, and funded by Helsinn Healthcare, SA, Lugano, Switzerland. The survey was funded by Helsinn Healthcare, SA. The authors are fully responsible for all content and editorial decisions for this paper.

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Authors and Affiliations

  1. Gustave Roussy Institute of Oncology, Villejuif, France

    Pascale Dielenseger

  2. Cadre de Département DITEP, Département des Innovations Thérapeutiques et Essais Précoces, Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France

    Pascale Dielenseger

  3. Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Linköping, Sweden

    Sussanne Börjeson

  4. Nursing and Governance, Alcura UK Ltd, Northampton, UK

    Cheryl Vidall

  5. Cancer Research Centre, University Hospitals Coventry and Warwickshire, Coventry, UK

    Annie Young

  6. Nursing Research Unit, University Hospital Halle (Saale), Halle, Germany

    Patrick Jahn

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  1. Pascale Dielenseger
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  2. Sussanne Börjeson
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  3. Cheryl Vidall
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  4. Annie Young
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  5. Patrick Jahn
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Corresponding author

Correspondence to Pascale Dielenseger.

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Conflict of interest

The authors have the following conflicts of interest to disclose:

Dielenseger: Advisory boards: Helsinn, Roche, Shire, Tesaro, BMS, Pfizzer, Janssen Cilag, Bayer Healthcare, IPSEN.

Börjeson: None.

Vidall: None.

Young: Honoraria from Helsinn, Bayer, Leo Pharma; Educational grant from Bayer.

Jahn: Travel support: Helsinn (2014); Consulting or Advisory role: Bristol-Myers Squibb, Chugai, Norgine and Clinigen; Clinical Research Fund by Chugai

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Dielenseger, P., Börjeson, S., Vidall, C. et al. Evaluation of antiemetic practices for prevention of chemotherapy-induced nausea and vomiting (CINV): results of a European oncology nurse survey. Support Care Cancer 27, 4099–4106 (2019). https://doi.org/10.1007/s00520-019-04697-1

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