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CP-135 Prevention and treatment of chemotherapy-induced nausea and vomiting in breast cancer patients
  1. JC Roldán1,
  2. E Campos-Davila1,
  3. D Guerra Estévez1,
  4. JJ Ramos-Báez2,
  5. E Márquez-Fernández2,
  6. B Marmesat Rodas2
  1. 1Hospital Sas La Linea, Pharmacy, La Linea de La Concepcion, Spain
  2. 2Campo de Gibraltar Healthcare Area, Pharmacy, Algeciras, Spain

Abstract

Background Pharmacists prescribe and monitor, in consensus with Oncology, individualised Post-Chemotherapy antiemetic regimes for all patients in our Hospital.

Purpose To evaluate the quality and the acceptance of the antiemetic treatment prescribed to breast cancer (BC) patients in the last five years.

Material and methods Retrospective observational study of BC patients treated with standard chemotherapy who received antiemetic treatment between 2008 and 2013. Depending on the emetogenic potential (EP) of the chemotherapy scheme, the pharmacist assigned and explained to the patient/family the most suitable antiemetic regime as:

  • Low EP: metoclopramide 10–20 mg tds as needed (PRN).

  • Moderate EP (Kit-1): dexamethasone 4 mg tds 2 days, then 4 mg bid 2 days, then 4 mg od 2 days, and metoclopramide 10–20 mg tds PRN.

  • High EP (Kit-3): Kit-1 plus granisetron 1 mg in the evening following chemotherapy.

If the patient had no emesis on the previous cycle, the regime was reduced, but if nausea/vomiting were felt, the regime was stepped up. Patient/family was always involved in treatment decisions. Patient data, prescriptions and monitoring were collected from the Oncofarm application and Pharmacy Database and analysed using SPSS.

Results 93 BC patients (all female) received a total of 400 chemotherapy cycles. 357 antiemetic prescriptions were dispensed, so 89.25% of the time a patient received chemotherapy, came to pharmacy for antiemetic drugs. 87.3% of anti-emesis patients started with Kit-3, and 12.9% with kit-1. Antiemetics were reduced in 63.4% of patients, 15.1% continued with the same regime and 21.5% required reinforcement: taking metoclopramide around-the-clock (16.1%), stepping up from kit-1 to kit-3 (3.2%) or adding lorazepam due to anticipatory nausea/vomiting (2.2%).

Conclusion The large number of antiemetic prescriptions states the good acceptance from patients of the healthcare provided by the pharmacy. Progressive reduction of antiemetics in more than 60% of patients shows the good control and monitoring of nausea/vomiting with the antiemetic treatment prescribed.

References and/or Acknowledgements No conflict of interest.

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