Abunahlah Nibal, Sancar Mesut, Dane Faysal, Özyavuz Mustafa Kerem
Department of Clinical Pharmacy, School of Pharmacy, Istanbul Kemerburgaz University, Istanbul, Turkey.
Department of Clinical Pharmacy, School of Pharmacy, Marmara University, Istanbul, Turkey.
Int J Clin Pharm. 2016 Dec;38(6):1464-1476. doi: 10.1007/s11096-016-0393-3. Epub 2016 Oct 28.
Background International guidelines are tools enabling physicians to incorporate the latest evidence based clinical information into practice. Objective This study aimed to evaluate the impact of antiemetic guidelines adherence on the incidence of chemotherapy-induced nausea and vomiting (CINV) and patient quality of life. Setting Marmara University Pendik Training and Research Hospital chemotherapy unit, Istanbul, Turkey. Method The study included 100 chemotherapy naive patients. Antiemetic prescribing patterns and their consistency with MASCC/ESMO 2014 guidelines were assessed. Patients recorded incidences of vomiting in a daily dairy and described their nausea using a 7-item Likert Scale. The incidence of CINV was recorded over five days. To assess the patient's quality of life, a modified Turkish version of the Functional Living Index-Emesis (FLIE) questionnaire was administered before and after receiving chemotherapy. A questionnaire on the existence and severity of side effects was developed and administered. Main outcome measures Incidence of side effects on CINV and quality of life according to the FLIE. Results The primary outcome revealed differences in complete control (no emetic episodes, rescue therapy or nausea), FLIE scores and side effects. Guidelines consistency was observed more with acute (A) than with delayed (D) prevention of CINV, with significant differences in complete control between the guideline adherent group (GAG) and the guideline nonadherent group (GNG). Significant differences in the FLIE score were noticed between GAG(D) and GNG(D), and GNG(D) had a higher incidence of diarrhoea, headache, swallowing difficulties and dark-coloured stool. Conclusion Consistency with guidelines resulted in significant reduction in the incidence of both cute and delayed CINV and other side effects, and with improvement of the patient quality of life.
背景 国际指南是帮助医生将最新的循证临床信息应用于实践的工具。目的 本研究旨在评估遵循止吐指南对化疗引起的恶心和呕吐（CINV）发生率及患者生活质量的影响。地点 土耳其伊斯坦布尔马尔马拉大学彭迪克培训与研究医院化疗科。方法 本研究纳入100例初治化疗患者。评估止吐药物的处方模式及其与MASCC/ESMO 2014指南的一致性。患者在每日日记中记录呕吐发生率，并使用7项李克特量表描述其恶心程度。记录5天内CINV的发生率。为评估患者的生活质量，在化疗前后使用改良的土耳其语版功能性生活指数-呕吐（FLIE）问卷。编制并发放一份关于副作用存在情况及严重程度的问卷。主要观察指标 根据FLIE评估CINV的副作用发生率及生活质量。结果 主要结果显示在完全控制（无呕吐发作、解救治疗或恶心）、FLIE评分和副作用方面存在差异。观察到在急性（A）预防CINV方面比延迟（D）预防更符合指南，指南遵循组（GAG）和指南未遵循组（GNG）在完全控制方面存在显著差异。在GAG（D）和GNG（D）之间观察到FLIE评分存在显著差异，并且GNG（D）腹泻、头痛、吞咽困难和黑便的发生率更高。结论 与指南保持一致可显著降低急性和延迟性CINV及其他副作用的发生率，并改善患者生活质量。
