Pascale Dielenseger1,2, Sussanne Börjeson3, Cheryl Vidall4, Annie Young5, Patrick Jahn6. 1. Gustave Roussy Institute of Oncology, Villejuif, France. pascale.dielenseger@gustaveroussy.fr. 2. Cadre de Département DITEP, Département des Innovations Thérapeutiques et Essais Précoces, Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France. pascale.dielenseger@gustaveroussy.fr. 3. Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Linköping, Sweden. 4. Nursing and Governance, Alcura UK Ltd, Northampton, UK. 5. Cancer Research Centre, University Hospitals Coventry and Warwickshire, Coventry, UK. 6. Nursing Research Unit, University Hospital Halle (Saale), Halle, Germany.
Abstract
INTRODUCTION: Preventing CINV is possible when guideline-recommended antiemetics are used. Because oncology nurses play a critical role in risk assessment and management of CINV, a survey of European nurses was conducted to evaluate antiemetic practices, assess awareness of and adherence to current guideline recommendations, and explore barriers to adherence. METHODS: From March 2016 to Feb 2017, 212 oncology nurses in 16 European countries completed a 20-question online survey. RESULTS: Respondents had 15-year (median) oncology nursing experience, and most (75%) were able to suggest or prescribe antiemetics. Most (80%) worked in the public not-for-profit hospital setting. Guideline awareness was generally low with nurses most familiar with ASCO (46%) and MASCC/ESMO (40%) guidelines; individual institution guidelines were most commonly used (47%). Key discrepancies between reported antiemetic use and guideline recommendations in the highly emetogenic chemotherapy (HEC) setting were underutilization of the recommended NK1RA + 5-HT3RA + steroid combination on day 1 (55%) and high use of 5-HT3RAs (50%) on days 2-5 when a steroid (63% use) should be used. Metoclopramide use was high in both HEC and moderately emetogenic settings, with ~ 30% and ~ 50% reporting use on day 1 and days 2-5, respectively. The most common reported barrier to use of guideline-recommended agents was physician preference (40%). The most common challenges in managing CINV were "controlling nausea/vomiting in the delayed phase" (64%) and "reducing the impact of CINV on patients' quality-of-life" (61%). CONCLUSIONS: This survey highlights opportunities to improve utilization of guideline-recommended antiemetics, thereby optimizing prevention of CINV and QoL for patients receiving emetogenic chemotherapy.
INTRODUCTION: Preventing CINV is possible when guideline-recommended antiemetics are used. Because oncology nurses play a critical role in risk assessment and management of CINV, a survey of European nurses was conducted to evaluate antiemetic practices, assess awareness of and adherence to current guideline recommendations, and explore barriers to adherence. METHODS: From March 2016 to Feb 2017, 212 oncology nurses in 16 European countries completed a 20-question online survey. RESULTS: Respondents had 15-year (median) oncology nursing experience, and most (75%) were able to suggest or prescribe antiemetics. Most (80%) worked in the public not-for-profit hospital setting. Guideline awareness was generally low with nurses most familiar with ASCO (46%) and MASCC/ESMO (40%) guidelines; individual institution guidelines were most commonly used (47%). Key discrepancies between reported antiemetic use and guideline recommendations in the highly emetogenic chemotherapy (HEC) setting were underutilization of the recommended NK1RA + 5-HT3RA + steroid combination on day 1 (55%) and high use of 5-HT3RAs (50%) on days 2-5 when a steroid (63% use) should be used. Metoclopramide use was high in both HEC and moderately emetogenic settings, with ~ 30% and ~ 50% reporting use on day 1 and days 2-5, respectively. The most common reported barrier to use of guideline-recommended agents was physician preference (40%). The most common challenges in managing CINV were "controlling nausea/vomiting in the delayed phase" (64%) and "reducing the impact of CINV on patients' quality-of-life" (61%). CONCLUSIONS: This survey highlights opportunities to improve utilization of guideline-recommended antiemetics, thereby optimizing prevention of CINV and QoL for patients receiving emetogenic chemotherapy.
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