title: Improving adherence with oral antiemetic agents in patients with breast cancer receiving chemotherapy.
abstract: OBJECTIVE
  In this small breast cancer-dedicated solo practice, a retrospective medical record review disclosed the following: significant rate of chemotherapy-related nausea and vomiting and discordance between patient-reported compliance with prescribed antiemetics and medical record documentation of compliance. As part of the curriculum for the American Society of Clinical Oncology (ASCO) Quality Training Program, a quality improvement project was developed to improve adherence to oral antiemetics in our patients with breast cancer receiving highly emetogenic chemotherapy.
  
  
  METHODS
  The following steps were undertaken in plan-do-study-act cycles to improve adherence: enhanced patient education at time of chemotherapy consent, implementation of standardized in-person or e-mail contact with our patients receiving chemotherapy, and improvement of our electronic health record documentation of adherence to oral antiemetics. A run chart was generated to analyze our data.
  
  
  RESULTS
  After our interventions, the percentage of patients who took their antiemetics as prescribed rose from a baseline of 49% to 79%.
  
  
  CONCLUSIONS
  Significant improvement in adherence to oral antiemetics among patients with breast cancer receiving chemotherapy was achieved and sustained in this small-practice setting using the framework provided by participation in the ASCO Quality Training Program.
authors: Center for Breast Health, Bethesda, MD carolyn.hendricks53@verizon.net.
authors: Carolyn B
authors: CB
authors: Hendricks
mesh_terms: D000284:Administration, Oral; D000932:Antiemetics / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D004334:Drug Administration Schedule; D057286:Electronic Health Records; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008495:Medical Oncology / Q000592:standards; D016347:Medical Records Systems, Computerized; D055118:Medication Adherence; D009325:Nausea / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control*; D010353:Patient Education as Topic; D015397:Program Evaluation; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents