Obstacles to the Implementation of Antiemetic Guidelines

Author:
Steven M. GrunbergDivision of Hematology/Oncology, University of Vermont College of Medicine, Burlington, Vermont

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Volume/Issue:
Volume 7: Issue 5
Online Publication Date:
May 2009
DOI:
https://doi.org/10.6004/jnccn.2009.0040
Full access

Although guidelines help physicians deliver high quality clinical care, they will have minimal impact unless familiarity and adherence are achieved. Although nausea and vomiting are highly feared toxicities of chemotherapy that markedly decrease patient quality of life, modifications in physician behavior and improvements in standards of care, particularly in terms of preventing delayed emesis, have been slow. Variations in format, goals, physician education, and institutional education may all affect guideline implementation and state-of-the-art care. The relationship between these factors and the scientific basis of antiemetic guidelines must be considered to achieve optimal results and compliance.

Correspondence: Steven Grunberg, MD, Division of Hematology/Oncology, 89 Beaumont Avenue, Given Building E214, Burlington, VT 05405. E-mail: Steven.Grunberg@uvm.edu
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  • 1

    Field MJ, Lohr KN. Clinical Practice Guidelines: Directions of a New Program. Washington, DC: National Academy Press; 1990.

  • 2

    Coates A, Abraham S, Kaye SB et al.. On the receiving end – patient perception of the side-effects of cancer chemotherapy. Eur J Cancer Clin Oncol 1983;19:203–208.

    • Search Google Scholar
    • Export Citation
  • 3

    Sun CC, Bodurka BC, Weaver CB et al.. Rankings and symptom assessments of side effects of chemotherapy: insights from experienced patients with ovarian cancer. Support Care Cancer 2005;13:219–227.

    • Search Google Scholar
    • Export Citation
  • 4

    Sun CC, Bodurka DC, Donato ML et al.. Patient preferences regarding side effects of chemotherapy for ovarian cancer: do they change over time? Gynecol Oncol 2002;87:118–128.

    • Search Google Scholar
    • Export Citation
  • 5

    Ettinger DS, Bierman PJ, Bradbury B et al.. Antiemesis. J Natl Compr Canc Netw 2007;5:12–33.

  • 6

    Kris MG, Hesketh PJ, Somerfield MR et al.. American Society of Clinical Oncology guideline for antiemetics in oncology: update 2006. J Clin Oncol 2006;24:2932–2947.

    • Search Google Scholar
    • Export Citation
  • 7

    Antiemetic Subcommittee of the Multinational Association of Supportive Care in Cancer (MASCC). Prevention of chemotherapy- and radiotherapy-induced emesis: results of the 2004 Perugia International Antiemetic Consensus Conference. Ann Oncol 2006;17:20–28.

    • Search Google Scholar
    • Export Citation
  • 8

    American Society of Health-System Pharmacists. ASHP therapeutic guidelines on the pharmacologic management of nausea and vomiting in adult and pediatric patients receiving chemotherapy or radiation therapy or undergoing surgery. Am J Health Syst Pharm 1999;56:729–764.

    • Search Google Scholar
    • Export Citation
  • 9

    Herrstedt J, Roila F. Chemotherapy-induced nausea and vomiting: ESMO clinical recommendations for prophylaxis. Ann Oncol 2008;19(Suppl 2):ii110–ii112.

    • Search Google Scholar
    • Export Citation
  • 10

    Rawlins MD. NICE work—providing guidance to the British National Health Service. N Engl J Med 2004;351:1383–1385.

  • 11

    Somerfield MR, Einhaus K, Hagerty KL et al.. American Society of Clinical Oncology clinical practice guidelines: opportunities and challenges. J Clin Oncol 2008;26:4022–4026.

    • Search Google Scholar
    • Export Citation
  • 12

    Gralla RJ, Roila F, Tonato M. The 2004 Perugia Antiemetic Consensus Guideline process: methods, procedures, and participants. Support Care Cancer 2005;13:77–79.

    • Search Google Scholar
    • Export Citation
  • 13

    Winn RJ, McClure JS. About the NCCN Clinical Practice Guidelines in Oncology. Available at: http://www.nccn.org/professionals/physician_gls/about.asp. Accessed December 29, 2008.

    • Search Google Scholar
    • Export Citation
  • 14

    Steinbrook R. Saying no isn’t NICE—the travails of Britain’s National Institute for Health and Clinical Excellence. N Engl J Med 2008;359:1977–1980.

    • Search Google Scholar
    • Export Citation
  • 15

    Steinbrook R. Guidance for guidelines. N Engl J Med 2007;356:331–333.

  • 16

    Tunis SR, Hayward RS, Wilson MC et al.. Internists’ attitudes about clinical practice guidelines. Ann Intern Med 1994;120:956–963.

  • 17

    Italian Group for Antiemetic Research. Transferability to clinical practice of the results of controlled clinical trials: the case of antiemetic prophylactic treatment for cancer chemotherapy-induced nausea and vomiting. Ann Oncol 1998;9:759–765.

    • Search Google Scholar
    • Export Citation
  • 18

    De Angelis V, Roila F, Sabbatini R et al.. Cancer chemotherapy-induced delayed emesis: antiemetic prescriptions in clinical practice [abstract]. Proc Am Soc Clin Oncol 2003;22:739. Abstract 2971.

    • Search Google Scholar
    • Export Citation
  • 19

    Grunberg SM, Deuson RR, Mavros P et al.. Incidence of chemotherapy-induced nausea and emesis after modern antiemetics. Cancer 2004;15:2261–2268.

  • 20

    Ihbe-Heffinger A, Ehlken B, Bernard R et al.. The impact of delayed chemotherapy-induced nausea and vomiting on patients, health resource utilization and costs in German cancer centers. Ann Oncol 2004;15:526–536.

    • Search Google Scholar
    • Export Citation
  • 21

    Burgers JS, Grol RP, Zaat JO et al.. Characteristics of effective clinical guidelines for general practice. Br J Gen Pract 2003;53:15–19.

  • 22

    Ettinger DS, Grunberg SM, Hauber AB, Mohamed AF. Evaluation of the relative importance of chemotherapeutic and antiemetic efficacy in various oncologic settings. Support Care Cancer 2009;17:405–411.

    • Search Google Scholar
    • Export Citation
  • 23

    Grunberg S, Ettinger D, Hauber AB, Mohamed A. How familiar are oncologists with therapeutic care and supportive care guidelines? [abstract]. Support Care Cancer 2008;16:631–632. Abstract 01-007.

    • Search Google Scholar
    • Export Citation
  • 24

    Kaiser R. Antiemetic guidelines: are they being used? Lancet Oncol 2005;6:622–625.

  • 25

    Lomas J, Anderson GM, Domnick-Pierre K et al.. Do practice guidelines guide practice? The effect of a consensus statement on the practice of physicians. N Engl J Med 1989;321:1306–1311.

    • Search Google Scholar
    • Export Citation
  • 26

    Drug Utilization Review Team in Oncology. Antiemetic prescription in Italian breast cancer patients submitted to adjuvant chemotherapy. Support Care Cancer 2003;11:785–789.

    • Search Google Scholar
    • Export Citation
  • 27

    Lomas J, Enkin M, Anderson GM et al.. Opinion leaders vs audit and feedback to implement practice guidelines. Delivery after previous cesarean section. JAMA 1991;265:2202–2207.

    • Search Google Scholar
    • Export Citation
  • 28

    Mertens WC, Higby DJ, Brown D et al.. Improving the care of patients with regard to chemotherapy-induced nausea and emesis: the effect of feedback to clinicians on adherence to antiemetic prescribing guidelines. J Clin Oncol 2003;21:1373–1378.

    • Search Google Scholar
    • Export Citation
  • 29

    Berard CM, Mahoney CD. Cost-reducing treatment algorithms for antineoplastic drug-induced nausea and vomiting. Am J Health Syst Pharm 1995;52:1879–1885.

    • Search Google Scholar
    • Export Citation
  • 30

    Engstrom C, Hernandez I, Haywood J, Lilenbaum R. The efficacy and cost effectiveness of new antiemetic guidelines. Oncol Nurs Forum 1999;26:1453–1458.

    • Search Google Scholar
    • Export Citation
  • 31

    Mutnick AH, Szymusiak-Mutnick BA. Locally derived clinical practice guidelines using a decision analysis model. AACN Clinical Issues 1996;7:448–455.

    • Search Google Scholar
    • Export Citation
  • 32

    Loprinzi Cl, Alberts SR, Christensen BJ et al.. History of the development of antiemetic guidelines at Mayo Clinic Rochester. Mayo Clin Proc 2000;75:303–309.

    • Search Google Scholar
    • Export Citation
  • 33

    Nolte MJ, Berkery R, Pizzo B et al.. Assuring the optimal use of serotonin antagonist antiemetics: the process for development and implementation of institutional antiemetic guidelines at Memorial Sloan-Kettering Cancer Center. J Clin Oncol 1998;16:771–778.

    • Search Google Scholar
    • Export Citation
  • 34

    Grol R, Dalhuijsen J, Thomas S et al.. Attributes of clinical guidelines that influence use of guidelines in general practice: observational study. BMJ 1998;317:858–861.

    • Search Google Scholar
    • Export Citation
  • 35

    Pirates of the Caribbean: The Curse of the Black Pearl (2003)—Memorable Quotes. Available at: http://www.imdb.com/title/tt0325980/quotes. Accessed December 18, 2008.

    • Search Google Scholar
    • Export Citation
  • 36

    Fabiola G. Wrong diagnosis and unnecessary removal of the appendix. Available at: http://www.articlejoe.com/article.php?id=34843&act=print. Accessed December 29, 2008.

    • Search Google Scholar
    • Export Citation
Copyright:
Copyright © 2009 by the National Comprehensive Cancer Network 2009
Page Numbers:
5
Article Category:
Research Article
Received:
01 Jan 2009
Accepted:
05 Mar 2009
Print Publication Date:
01 May 2009
Online Publication Date:
May 2009
Keywords:
Guidelines; vomiting; nausea; antiemetics
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