Genolier Cancer Centre, Clinique de Genolier, Genolier, Switzerland.
Department of Market Access, Helsinn Healthcare SA, Pazzallo (Lugano), Switzerland.
Cancer Rep (Hoboken). 2018 Dec;1(4):e1127. doi: 10.1002/cnr2.1127. Epub 2018 Oct 9.
Chemotherapy-induced nausea and vomiting (CINV) is a distressing side effect that can negatively impact patients' quality of life and could discourage completion of chemotherapy, thereby affecting overall treatment outcomes. Although adherence to antiemetic guidelines can reduce CINV incidence in patients receiving highly or moderately emetogenic chemotherapy, CINV control remains inadequate.
The objectives of this survey were to determine oncologists' practice patterns in CINV management, identify factors that contribute to antiemetic treatment failure, and determine the outcomes of uncontrolled CINV on health care resource utilisation and on patients' attitude towards chemotherapy.
Quantitative market research was performed using an online questionnaire. Responses from 300 European oncologists who prescribe antiemetics and see ≥50 patients/month were analysed. Results showed that the main reasons reported by oncologists for antiemetic treatment failure were underestimating the emetogenic potential of chemotherapy, utilising weaker antiemetic regimens than required, and patient non-adherence because of administration mistakes or missed/delayed doses. Educational initiatives for the oncology multidisciplinary team may help improve guideline-consistent prescribing. Also, the availability of simpler, more convenient antiemetic therapies may improve guideline adherence and patient compliance during home administration.
Achieving effective CINV control is a crucial goal to improve patients' quality of life, which should optimise chemotherapy outcomes, and would ultimately reduce health care costs.
化疗引起的恶心和呕吐（CINV）是一种令人痛苦的副作用，会对患者的生活质量产生负面影响，并可能阻止化疗的完成，从而影响整体治疗效果。尽管遵循止吐指南可以降低接受高或中度致吐性化疗的患者的 CINV 发生率，但 CINV 的控制仍然不足。
本调查的目的是确定肿瘤学家在 CINV 管理方面的实践模式，确定导致止吐治疗失败的因素，并确定未控制的 CINV 对医疗资源利用和患者对化疗态度的影响。
采用在线问卷进行定量市场研究。对 300 名开处方止吐药且每月看诊≥50 名患者的欧洲肿瘤学家的回复进行了分析。结果表明，肿瘤学家报告的止吐治疗失败的主要原因是低估化疗的致吐潜能、使用比所需弱的止吐方案以及因给药错误、漏用或延迟剂量导致患者不遵医嘱。肿瘤多学科团队的教育举措可能有助于改善指南一致的处方。此外，更简单、更方便的止吐疗法的可用性可能会提高指南的依从性，并提高患者在家中给药时的依从性。
实现有效的 CINV 控制是改善患者生活质量的关键目标，这将优化化疗结果，并最终降低医疗成本。
