The efficacy and cost effectiveness of new antiemetic guidelines.
OBJECTIVE
To develop antiemetic guidelines to improve efficacy, optimize nursing and pharmacy time, increase compliance, and enhance cost savings.


METHODS
Prospective, descriptive survey.


METHODS
Outpatient oncology clinic in a large metropolitan city in the mid-Atlantic United States.


METHODS
90 patients were evaluated for the study; 52 patients met the eligibility criteria.


METHODS
A standard antiemetic form was developed containing the emetogenic classification of the chemotherapeutic drugs and the recommended antiemetic regimen. A patient diary and visual analog scale measured patient satisfaction with the regimen-measured outcomes.


METHODS
Episodes of nausea and vomiting, classification of chemotherapeutic drugs, and patient satisfaction.


RESULTS
Seventy-nine percent of patients receiving highly emetogenic chemotherapy demonstrated complete protection from nausea and vomiting during the first 24 hours post-therapy. All the patients receiving moderately and mildly emetogenic regimens achieved complete protection. Patients who received cisplatin-containing regimens and were on the delayed regimen of antiemetics demonstrated complete protection on days two through seven. The mean overall score for patient satisfaction with the regimen was 89 mm on a 100 mm visual analog scale.


CONCLUSIONS
The new oral antiemetic regimen compared favorably with published data, was well-tolerated, and resulted in lower pharmacy and nursing costs, with a cost saving potential of $20,000 per year.


CONCLUSIONS
Oncology nurses must be able to implement state-of-the-art knowledge of chemotherapy, antiemetics, and nonpharmacologic interventions to effectively manage the care of patients receiving chemotherapy. This must be performed to achieve cost effectiveness as well as useful clinical outcomes.
Engstrom
C
C
VA Maryland Health Care System, Baltimore, USA. chriseng@gateway.net
Hernandez
I
I
Haywood
J
J
Lilenbaum
R
R
D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000145:classification / Q000191:economics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced* / Q000188:drug therapy* / Q000523:psychology; D009859:Oncology Nursing / Q000191:economics; D010349:Patient Compliance / Q000523:psychology; D017060:Patient Satisfaction; D010607:Pharmacy Service, Hospital / Q000191:economics; D017410:Practice Guidelines as Topic / Q000592:standards*; D011446:Prospective Studies; D012720:Severity of Illness Index; D017749:Total Quality Management / Q000458:organization & administration; D014839:Vomiting / Q000139:chemically induced* / Q000188:drug therapy* / Q000523:psychology
D000932:Antiemetics; D000970:Antineoplastic Agents