School of Nursing, University of Manchester, Manchester, UK.
Support Care Cancer. 2011 Jul;19(7):949-56. doi: 10.1007/s00520-010-0909-7. Epub 2010 Jun 24.
The main aim of the present study was to assess antiemetic prescriptions used during chemotherapy and identify if these are in agreement with internationally agreed consensus guidelines (MASCC/ASCO).
A web-based survey in the UK was carried out collecting data through a 32-item questionnaire using a snowball sampling technique and the email lists of two large oncology societies in the country.
The participants were 154 oncologists and oncology nurse prescribers. Data showed a great variability in antiemetic prescriptions used, most not been in accordance with MASCC/ASCO consensus guidelines. The variability was also reflected in the doses of antiemetics used. Overall, clinicians undertreated patients receiving highly emetogenic chemotherapy and overtreated patients receiving low and minimally emetogenic chemotherapy. Eight of ten clinicians, however, prescribed antiemetics in accordance with consensus guidelines in moderately emetogenic chemotherapy. There was more agreement between clinicians and guidelines for acute nausea/vomiting and less for delayed symptoms. The uptake of MASCC/ASCO guidelines was minimal.
The low level of agreement between actual clinical practice and evidence-based consensus guidelines may be one of the reasons for the considerable incidence of chemotherapy-related nausea and vomiting. There is a need to utilise consensus guidelines more widely and educate clinicians on this aspect of supportive care.
本研究的主要目的是评估化疗期间使用的止吐处方，并确定这些处方是否与国际公认的共识指南（MASCC/ASCO）一致。
在英国进行了一项基于网络的调查，通过使用滚雪球抽样技术和该国两个大型肿瘤学会的电子邮件列表，收集了 32 项问卷的数据。
参与者为 154 名肿瘤学家和肿瘤护士处方者。数据显示，使用的止吐处方存在很大的差异，大多数处方与 MASCC/ASCO 共识指南不一致。使用的止吐剂剂量也存在差异。总体而言，临床医生对接受高度致吐性化疗的患者治疗不足，对接受低度和轻度致吐性化疗的患者过度治疗。然而，十分之八的临床医生在中度致吐性化疗中按照共识指南开具了止吐药。对于急性恶心/呕吐，临床医生和指南之间的一致性更高，而对于延迟症状则一致性较低。MASCC/ASCO 指南的采用率很低。
实际临床实践与基于证据的共识指南之间的低一致性可能是化疗相关恶心和呕吐发生率较高的原因之一。需要更广泛地使用共识指南，并在这方面对临床医生进行支持性护理教育。
