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Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting
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Adherence to pediatric acute chemotherapy-induced nausea and vomiting guidelines in Canadian hospitals

Krista McKinnon1, Jennifer Jupp1, Sunita Ghosh2

  • 1Pharmacy Services, Alberta Children's Hospital, Alberta Health Services, Calgary, Canada.

Pediatric Blood & Cancer
|October 16, 2018
PubMed

Insights

Pediatric cancer patients show low adherence to chemotherapy-induced nausea and vomiting (CINV) guidelines. This resulted in poor CINV control, highlighting a need for improved treatment strategies in pediatric oncology care.

Area of Science:

  • Pediatric Oncology
  • Clinical Pharmacy
  • Evidence-Based Medicine

Background:

  • Chemotherapy-induced nausea and vomiting (CINV) significantly affects pediatric cancer patients' quality of life.
  • Recent guidelines for CINV classification and prevention in children have been endorsed by major pediatric oncology organizations.

Purpose of the Study:

  • To evaluate the adherence rates to pediatric CINV guidelines across four Canadian pediatric oncology centers.
  • To assess the impact of guideline adherence on CINV control in children receiving highly or moderately emetogenic chemotherapy.

Main Methods:

  • A multicenter chart review was conducted for 204 pediatric patients receiving their first chemotherapy course (highly emetogenic chemotherapy [HEC] or moderately emetogenic chemotherapy [MEC]) between 2012 and 2015.
  • Guideline adherence was assessed based on antiemetic-only guideline adherence (AGA) and complete guideline adherence (CGA), considering medication, dose, frequency, and duration.

Main Results:

  • Overall guideline adherence was low: 29% for AGA and 2% for CGA.
  • Vomiting occurred in 24% of AGA patients versus 34% of non-AGA patients (P=0.13).
  • Complete CINV control in the first 24 hours was achieved by 37% of HEC AGA patients vs. 45% of non-AGA patients (P=0.31), and 80% of MEC AGA patients vs. 24% of non-AGA patients (P=0.02).

Conclusions:

  • Adherence to pediatric CINV guidelines was suboptimal across participating institutions.
  • Varied implementation strategies for CINV guidelines were observed among centers.
  • Low complete CINV control rates and high instances of emesis indicate that pediatric patients are not receiving optimal antiemetic treatment.
Abstract

Keywords:
chemotherapynauseapediatricssupportive carevomiting

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