Chemotherapy-Induced Nausea and Vomiting Prophylaxis: Practice Within the Children's Oncology Group

Priya Patel, Paula D. Robinson, Andrea Orsey, Jason L. Freedman, Anne Marie Langevin, Debbie Woods, Lillian Sung, L. Lee Dupuis

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background: The Children's Oncology Group (COG) has endorsed a clinical practice guideline (CPG) for acute chemotherapy-induced nausea and vomiting (CINV) prophylaxis in children with cancer. This project aims to describe current acute CINV prophylaxis practice at COG sites and the gap between this practice and CPG recommendations. Procedure: Two surveys were developed. The first survey, sent to 94 cancer control and supportive care responsible individuals (CCL RIs) at 94 COG institutions, asked if the institution had a standardized approach to practice and focused on antiemetic agent choice. The second survey, sent to 54 pharmacists at COG sites where the CCL RI indicated that there was a standardized approach to CINV prophylaxis practice, focused on antiemetic dosing. Survey results were described and analyzed for consistency with the CPG recommendations. Results: Among the 69 respondents to the first survey, 54 (78%) stated that their institutions have a standardized approach to CINV prophylaxis practice. However, antiemetic choice varied widely among respondents. Results from the 36 respondents to the second survey also demonstrated significant antiemetic dosing practice variability. Frequent sources of deviation from CPG recommendations were as follows: antiemetic choice when corticosteroids are contraindicated, dexamethasone dosing, aprepitant use in children less than 12 years, and aprepitant use in the presence of a known or suspected drug interaction. Conclusions: There is a great diversity in the CINV prophylaxis provided to children with cancer at COG sites. Concerted strategies are required to improve awareness of the current CINV prophylaxis CPG and to facilitate CPG-consistent CINV prophylaxis.

Original languageEnglish (US)
Pages (from-to)887-892
Number of pages6
JournalPediatric Blood and Cancer
Volume63
Issue number5
DOIs
StatePublished - May 1 2016

Keywords

  • Antiemetic
  • Chemotherapy-induced vomiting
  • Nausea
  • Pediatrics
  • Supportive care
  • Vomiting

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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