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An audit of chemotherapy-induced nausea and vomiting in children

Frieda Clinton1, Maura Dowling, Michael Capra

  • 1Haematology Oncology Unit, Our Lady's Children's Hospital, Dublin, Ireland. frieda.clinton@olchc.ie

Nursing Children and Young People
|November 20, 2012
PubMed

Insights

Management of chemotherapy-induced nausea and vomiting (CINV) in children lacked consistency, with anti-emetic use often mismatched to chemotherapy risk. Improved guidelines and education are recommended for better CINV control in pediatric cancer patients.

Area of Science:

  • Pediatric Oncology
  • Clinical Pharmacy
  • Cancer Supportive Care

Background:

  • Chemotherapy-induced nausea and vomiting (CINV) is a significant challenge in pediatric cancer care, impacting treatment adherence and quality of life.
  • Current management practices for CINV in children may not align with the emetogenic potential of chemotherapy regimens.
  • Inconsistent anti-emetic prescribing and utilization can lead to suboptimal symptom control and patient distress.

Purpose of the Study:

  • To audit the current management of CINV in a national Irish pediatric cancer unit.
  • To assess the relationship between anti-emetic prescription and the emetogenic potential of chemotherapy in pediatric patients.
  • To identify areas for improvement in CINV management protocols.

Main Methods:

  • A prospective audit of anti-emetic medication and CINV incidence was conducted over three months.
  • Data were collected from 50 consecutive patient episodes involving 25 children receiving chemotherapy for various malignancies.
  • Analysis focused on anti-emetic prescribing patterns relative to chemotherapy emetogenicity and patient outcomes post-discharge.

Main Results:

  • Anti-emetic prescription was frequently unrelated to the emetogenic potential of chemotherapy, resulting in variable effectiveness.
  • Dexamethasone, a key anti-emetic, was underutilized, prescribed in only one case.
  • Twenty children did not receive anti-emetics upon discharge, with 11 experiencing delayed vomiting.

Conclusions:

  • Evidence-based guidelines for CINV management in pediatric oncology are necessary, ensuring anti-emetic prescription is proportional to chemotherapy risk.
  • Enhanced education for healthcare staff, patients, families, and caregivers regarding the importance and appropriate use of anti-emetics post-discharge is crucial.
  • Implementation of standardized, evidence-based protocols can significantly improve CINV control and patient well-being during pediatric cancer treatment.

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