Background Chemotherapy induced nausea and vomiting have an impact on the quality of social and professional life and they may also be responsible for metabolic complications. Antiemetic prophylaxis is therefore important for a favourable recovery prognosis.
Purpose To provide a support platform for the control and validation of chemotherapy protocols by hospital pharmacists through assessment of antiemetic (AE) prescriptions and their appropriateness to international recommendations.
Material and methods Setting: a retrospective study for the year 2014. Method: paediatric patients hospitalised on chemotherapy were included. Data on anthropometric characteristics of the patients, their age, chemotherapy cures and associated antiemetic medication were obtained from the prescriptions sent to the pharmacy. First, the emetic level of each protocol was determined. Then, we evaluated adherence to standard references in prescribing antiemetics. The Francophone Association of Oncologic Supportive Care and US National Cancer Institute guidelines were taken as golden standards.
Results We assessed 11 children and 20 chemotherapy protocols. During the study period, the average age was 5 years and the male/female ratio was 5.5. Median duration of chemotherapy cures was 32 days. 81% of patients received at least one antiemetic during their therapy. Only two antiemetic classes were used: corticosteroids and 5-HT3 antagonists. From the 20 protocols, only 15% of prescriptions followed the recommendations and 50% did not follow them. For the remaining 35%, they were incomplete. According to the guidelines, antiemetics are recommended for chemotherapies with low to high emetic potential (as primary or secondary prophylaxis) and very low emetic potential as a secondary prophylaxis.15% of protocols strictly adhered to the recommendations compared with 50% which did not; 35% partially adhered to the recommendations (non-prescription of aprepitant and NK1 antagonists because of their unavailability on the market).
Conclusion Antiemetics are not always adapted accordingly. Antiemetic control involves evaluation of chemotherapy emetic potential and appreciation of patient specific variation factors. A multidisciplinary collaboration between health professionals is crucial. Support, including criteria such as antiemetics prescribed in paediatric units, chemotherapy emetic level, type of CINV, lifestyle and dietary rules will permit an efficient pharmacist to review prescribed antiemetics and therefore will have a positive influence on therapy quality, patient well being and healthcare costs.
No conflict of interest.
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