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Abstract
Background In 2009, new guidelines were issued on the prevention and treatment of nausea and vomiting induced by chemotherapy. In the context of V2010 certification, a first evaluation was performed of professional practice in drug treatment for patients with lung cancer.
Purpose To evaluate the effectiveness of the improvements made following the first evaluation.
Material and methods In 2013, a prospective study was performed over two months using the same questionnaire as in 2010. Data collection was done by the pharmaceutical team during day care or conventional hospitalisation of patients. The results were analysed and compared to those obtained in 2010 using the Chi square and the Fischer test methods at α risk of 5%.
Results 33 questionnaires were identified. The proportion of women (36%) was higher than previously (15%) but no differences were observed in average age or mean creatinine clearance. Distribution of diagnoses, emetic power of protocols followed (high, medium and low), average number of days in hospital, number of drugs per protocol, duration of treatment and cisplatin fractionation were no different. Nausea and vomiting were better assessed and reported in patient records (58% in 2010 to 76% in 2013). An improvement in application of the American Society of Clinical Oncology recommendations for antiemetic treatment including an increase in the prescription of aprepitant were observed (p < 0.001). Less difference between the reference antiemetic protocol and actual prescriptions was observed (p < 0.001).
Conclusion The modifications made in 2010 (change of antiemetic protocols in the Chimio software and implementation of a prescribing model, based on the emetic protocol) have had a positive effect and helped improve drug treatment of nausea and vomiting. The new recommendations are being followed more closely including the prescription of aprepitant, optimising care. However, standardisation of care must not compromise the individual adaptability of anti-emetic treatment.