Chemotherapy induced nausea and vomiting: a European perspective.

International guidelines have been available for the successful management of chemotherapy-induced nausea and vomiting (CINV) for several years, yet the experience of patients receiving chemotherapy continues to reflect variable symptom control. This article explores the clinical awareness and application of the guidelines across several European countries from the perspective of the nurses working in oncology units and centres who met at an expert European forum in London in June 2010. It will also identify the existing barriers to the use of best practice guidelines and some of the reasons why clinicians may not be aware of this guidance. There will be some discussion around the use of individualized risk assessments and the prescribing of the most appropriate antiemetic to meet the needs of the individual patient. It will also consider the hospital-produced algorithms and local drug protocols and the limitations on being able to deliver optimal symptom control from day one of cycle one. The role of the nurse in providing holistic care is key to making the experience for chemotherapy patients one to remember, not one they will never forget.