Comparison of healthcare resource use between patients receiving ondansetron or palonosetron as prophylaxis for chemotherapy-induced nausea and vomiting.
OBJECTIVE
To analyze the differences between ondansetron and palonosetron in healthcare resource use (i.e., inpatient/ outpatient encounters) among patients receiving intraperitoneal cisplatin.


METHODS
A medical record review was performed. Intraperitoneal cisplatin administrations for gynecological cancers from January through June 2006 and from October 2007 through June 2008 were divided into two groups based on the serotonin-receptor antagonist used. The occurrence of chemotherapy-induced nausea and vomiting (CINV)-related hospital readmissions, emergency department visits, and outpatient encounters occurring within 7 days after cisplatin administration was compared. CINV-related resource use was defined as events associated with dehydration, hypovolemia, nausea/vomiting, hypokalemia, constipation, shortness of breath, or syncope/collapse.


RESULTS
Ondansetron or palonosetron was used in 39 and 89 cisplatin administrations, respectively. The baseline characteristics were similar between the groups with mean age of 59 years and ovarian cancer being the most common cancer. Length of stay was approximately 2 days. Palonosetron was always administered as a single-day therapy while one- or multi-day ondansetron therapy was administered in 27% and 73% of cycles, respectively. A trend towards more CINV-related hospitalizations with ondansetron versus palonosetron was observed (5.1% vs. 0%, p = 0.09) with no significant difference in other CINV-related encounters.


CONCLUSIONS
Palonosetron was associated with a trend to a lower risk of CINV-related hospital readmission than ondansetron in patients receiving intraperitoneal cisplatin for gynecological cancers, although not statistically significant. The duration of ondansetron therapy might be suboptimal with 27% of patients receiving only 1 day of therapy during hospital stay. These findings need to be confirmed in future studies.
Yeh
Yu-Chen
YC
Center for Drug Policy, Partners Healthcare, Needham, MA 02494, USA. yyeh@partners.org
McDonnell
Anne
A
Klinger
Elissa
E
Fowler
Bridget
B
Matta
Lina
L
Voit
Daniel
D
Reddy
Prabashni
P
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000932:Antiemetics / Q000008:administration & dosage* / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001900:Boston; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D057915:Drug Substitution; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005185:Fallopian Tube Neoplasms / Q000188:drug therapy; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D007546:Isoquinolines / Q000008:administration & dosage* / Q000009:adverse effects; D007902:Length of Stay; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D017294:Ondansetron / Q000008:administration & dosage* / Q000009:adverse effects; D010051:Ovarian Neoplasms / Q000188:drug therapy; D000077924:Palonosetron; D010359:Patient Readmission; D011292:Premedication; D011812:Quinuclidines / Q000008:administration & dosage* / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D012702:Serotonin Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
D000932:Antiemetics; D000970:Antineoplastic Agents; D007546:Isoquinolines; D011812:Quinuclidines; D012702:Serotonin Antagonists; D017294:Ondansetron; D000077924:Palonosetron; D002945:Cisplatin