Antiemetic therapy in Asia Pacific countries for patients receiving moderately and highly emetogenic chemotherapy—a descriptive analysis of practice patterns, antiemetic quality of care, and use of antiemetic guidelines

Purpose This paper reports prescribing patterns for prophylaxis of chemotherapy-induced nausea and vomiting (CINV) after highly or moderately emetogenic chemotherapy (HEC or MEC) for cancer in six Asia Pacific countries. Methods In a prospective noninterventional study, 31 sites in Australia, China,...

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Bibliographic Details
Published in:Supportive care in cancer 2015, Vol.23 (1), p.273-282
Main Authors: Yu, Shiying, Burke, Thomas A., Chan, Alexandre, Kim, Hoon-Kyo, Hsieh, Ruey Kuen, Hu, Xichun, Liang, Jin-Tung, Baños, Ana, Spiteri, Carmel, Keefe, Dorothy M. K.
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - therapeutic use
Aged
Analysis
Antiemetics
Antiemetics - therapeutic use
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Aprepitant
Asia
Cancer
Care and treatment
Chemotherapy
Clinical Protocols
Corticosteroids
Disease prevention
Evidence-based medicine
Female
Gastrointestinal agents
Glucocorticoids
Guidelines
Humans
Male
Medical care
Medical care quality
Medicine
Medicine & Public Health
Middle Aged
Nausea
Nausea - chemically induced
Nausea - drug therapy
Nausea - prevention & control
Neoplasms - drug therapy
Neurokinin-1 Receptor Antagonists - therapeutic use
Nursing
Nursing Research
Oncology
Pain Medicine
Palonosetron
Pantoprazole
Patient care
Patients
Practice Guidelines as Topic
Practice Patterns, Physicians
Prescription writing
Prescriptions
Preventive medicine
Prospective Studies
Quality management
Quality of care
Quality of Health Care
Rehabilitation Medicine
Serotonin 5-HT3 Receptor Antagonists - therapeutic use
Special Article
Steroids
Trends
Vomiting
Vomiting - chemically induced
Vomiting - drug therapy
Vomiting - prevention & control
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Summary:Purpose This paper reports prescribing patterns for prophylaxis of chemotherapy-induced nausea and vomiting (CINV) after highly or moderately emetogenic chemotherapy (HEC or MEC) for cancer in six Asia Pacific countries. Methods In a prospective noninterventional study, 31 sites in Australia, China, India, Singapore, South Korea, and Taiwan recorded details of CINV prophylaxis for the acute phase (first 24 h) and delayed phase (days 2–5) after single-day HEC or MEC for adult patients. Additional information on CINV prophylactic medications was collected from 6-day patient diaries. Primary antiemetic therapies were defined as corticosteroids, the 5-hydroxytryptamine-3 receptor antagonists (5HT3-RAs), and neurokinin-1 receptor antagonists (NK1-RAs). Results Evaluable patients in cycle 1 numbered 648 (318 [49 %] HEC and 330 [51 %] MEC) of mean (SD) age of 56 (12) years, including 58 % women. For the acute phase after HEC, overall (and country range), 96 % (91–100 %) of patients received a 5HT3-RA, 87 % (70–100 %) a corticosteroid, and 43 % (0–91 %) an NK1-RA. CINV prophylaxis for the HEC delayed phase was more variable: including 22 % (7–65 %) 5HT3-RA, 52 % (12–93 %) corticosteroid, and 46 % (0–88 %) NK1-RA. For the MEC acute phase, 97 % (87–100 %) of patients received 5HT3-RA and 86 % (73–97 %) a corticosteroid. For the MEC delayed phase, 201 patients (61 %) received a primary antiemetic, including 5HT3-RA (41 %), corticosteroid (37 %), and/or NK1-RA (4 %). Conclusions The 5HT3-RAs were prescribed consistently in all countries, while prescribing of other antiemetic therapies was variable, and corticosteroids were under-prescribed for CINV prophylaxis, particularly in the delayed phase.
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-014-2372-3