title: The efficacy and cost effectiveness of new antiemetic guidelines.
abstract: 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.
authors.affiliation: VA Maryland Health Care System, Baltimore, USA. chriseng@gateway.net
authors.forename: C
authors.initials: C
authors.lastname: Engstrom
authors.forename: I
authors.initials: I
authors.lastname: Hernandez
authors.forename: J
authors.initials: J
authors.lastname: Haywood
authors.forename: R
authors.initials: R
authors.lastname: Lilenbaum
mesh_terms: 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
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents