Evidence-based recommendations for cancer nausea and vomiting.
The experience of patients living with cancer and being treated with chemotherapy often includes the symptoms of nausea and vomiting. To provide a framework for high-quality management of these symptoms, we developed a set of key targeted evidence-based standards through an iterative process of targeted systematic review, development, and refinement of topic areas and standards and consensus ratings by a multidisciplinary expert panel as part of the RAND Cancer Quality-Assessing Symptoms Side Effects and Indicators of Supportive Treatment Project. For nausea and vomiting, key clinical standards included screening at the initial outpatient and inpatient visit, prophylaxis for acute and delayed emesis in patients receiving moderate to highly emetic chemotherapy, and follow-up after treatment for nausea and vomiting symptoms. In addition, patients with cancer and small bowel obstruction were examined as a special subset of patients who present with nausea and vomiting. The standards presented here for preventing and managing nausea and vomiting in cancer care should be incorporated into care pathways and should become the expectation rather than the exception.
Naeim
Arash
A
David Geffen School of Medicine, University of California, Los Angeles, CA, USA. anaeim@mednet.ucla.edu
Dy
Sydney M
SM
Lorenz
Karl A
KA
Sanati
Homayoon
H
Walling
Anne
A
Asch
Steven M
SM
D000932:Antiemetics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000077608:Aprepitant; D003907:Dexamethasone / Q000627:therapeutic use*; D015671:Electroacupuncture; D019317:Evidence-Based Medicine; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications*; D009025:Morpholines / Q000627:therapeutic use*; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology; D009369:Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D058831:Serotonin 5-HT3 Receptor Antagonists; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology
D000932:Antiemetics; D000970:Antineoplastic Agents; D009025:Morpholines; D058831:Serotonin 5-HT3 Receptor Antagonists; D000077608:Aprepitant; D003907:Dexamethasone