title: Evaluation of anti-emetic use in chemotherapy-induced nausea and vomiting in a third-world country (Lebanon).
abstract: BACKGROUND
  In Lebanon, the appropriateness of anti-emetic use is questionable in large measure because of the absence of published multicentre trials.
  
  
  OBJECTIVE
  To evaluate the extent of appropriateness of anti-emetic use in patients on chemotherapy among several Lebanese hospitals. Appropriateness of chemotherapy-induced nausea and vomiting (CINV) prophylaxis was determined as per National Comprehensive Cancer Network guidelines.
  
  
  METHODS
  A multicentre, cross-sectional study was conducted over a 3-month period. Data were collected from medical charts of cancer patients. The main outcome measure was to evaluate the appropriateness of prophylactic use of anti-emetics in CINV in terms of selected drug regimen, dosage and route of administration, and to investigate the role of several pre-specified variables (including hospital type and size, type of insurance coverage and patient-related factors) in influencing the appropriateness of anti-emetic practice.
  
  
  RESULTS
  A total of 493 patients' forms were analysed. The median age was 58.8 ± 13.9 years, 290 (58.8%) patients were female. Around 211 (42.8%) patients received inappropriate anti-emetic regimen, and only 17 (6%) patients of those receiving appropriate regimen received the appropriate dose, and just 55 (19.5%) patients were treated for the appropriate duration. Factors that may affect the relative effectiveness of treatment were identified.
  
  
  CONCLUSIONS
  This study reflected substantial flaws in CINV prophylaxis practice in Lebanon which should alert health care professionals of the adverse consequences resulting from non-adherence to guidelines. Our study also highlighted areas for improvement and suggested recommendations in order to minimize patient risk and optimize safe and effective CINV management.
authors: Pharmacy Practice Department, School of Pharmacy, Lebanese American University, Byblos, Lebanon. abeer.zeitoun@lau.edu.lb
authors: Abeer A
authors: AA
authors: Zeitoun
authors: Jeanette G
authors: JG
authors: Nassif
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004305:Dose-Response Relationship, Drug; D004333:Drug Administration Routes; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents