title: Assessment of adherence to the guidelines for the management of nausea and vomiting induced by chemotherapy.
abstract: OBJECTIVE
  To assess adherence of the prescribing physicians in a private cancer care center to the American Society of Clinical Oncology guideline for antiemetic prophylaxis, in the first cycle of antineoplastic chemotherapy.
  
  
  METHODS
  A total of 139 chemotherapy regimens, of 105 patients, were evaluated retrospectively from 2011 to 2013.
  
  
  RESULTS
  We observed 78% of non-adherence to the guideline rate. The main disagreements with the directive were the prescription of higher doses of dexamethasone and excessive use of 5-HT3 antagonist for low risk emetogenic chemotherapy regimens. On univariate analysis, hematological malignancies (p=0.005), the use of two or more chemotherapy (p=0.05) and high emetogenic risk regimes (p=0.012) were factors statistically associated with greater adherence to guidelines. Treatment based on paclitaxel was the only significant risk factor for non-adherence (p=0.02). By multivariate analysis, the chemotherapy of high emetogenic risk most correlated with adherence to guideline (p=0.05).
  
  
  CONCLUSIONS
  We concluded that the adherence to guidelines is greater if the chemotherapy regime has high emetogenic risk. Educational efforts should focus more intensely on the management of chemotherapy regimens with low and moderate emetogenic potential. Perhaps the development of a computer generated reminder may improve the adherence to guidelines.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Monique Sedlmaier
authors.initials: MS
authors.lastname: França
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Pedro Luiz Serrano
authors.initials: PL
authors.lastname: Usón Junior
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Yuri Philippe Pimentel Vieira
authors.initials: YP
authors.lastname: Antunes
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Bernard Lobato
authors.initials: BL
authors.lastname: Prado
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Carlos del Cistia
authors.initials: Cdel C
authors.lastname: Donnarumma
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Taciana Sousa
authors.initials: TS
authors.lastname: Mutão
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Heloisa Veasey
authors.initials: HV
authors.lastname: Rodrigues
authors.affiliation: Faculdade de Medicina do ABC, Santo André, SP, Brazil.
authors.forename: Auro del
authors.initials: Ad
authors.lastname: Giglio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D002173:Cancer Care Facilities; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D057970:Inappropriate Prescribing / Q000009:adverse effects*; D008175:Lung Neoplasms / Q000188:drug therapy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced* / Q000517:prevention & control; D012189:Retrospective Studies; D014839:Vomiting / Q000139:chemically induced* / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents