title: Chemotherapy-Induced Nausea and Vomiting Prophylaxis: Practice Within the Children's Oncology Group.
abstract: BACKGROUND
  The Children's Oncology Group (COG) has endorsed a clinical practice guideline (CPG) for acute chemotherapy-induced nausea and vomiting (CINV) prophylaxis in children with cancer. This project aims to describe current acute CINV prophylaxis practice at COG sites and the gap between this practice and CPG recommendations.
  
  
  METHODS
  Two surveys were developed. The first survey, sent to 94 cancer control and supportive care responsible individuals (CCL RIs) at 94 COG institutions, asked if the institution had a standardized approach to practice and focused on antiemetic agent choice. The second survey, sent to 54 pharmacists at COG sites where the CCL RI indicated that there was a standardized approach to CINV prophylaxis practice, focused on antiemetic dosing. Survey results were described and analyzed for consistency with the CPG recommendations.
  
  
  RESULTS
  Among the 69 respondents to the first survey, 54 (78%) stated that their institutions have a standardized approach to CINV prophylaxis practice. However, antiemetic choice varied widely among respondents. Results from the 36 respondents to the second survey also demonstrated significant antiemetic dosing practice variability. Frequent sources of deviation from CPG recommendations were as follows: antiemetic choice when corticosteroids are contraindicated, dexamethasone dosing, aprepitant use in children less than 12 years, and aprepitant use in the presence of a known or suspected drug interaction.
  
  
  CONCLUSIONS
  There is a great diversity in the CINV prophylaxis provided to children with cancer at COG sites. Concerted strategies are required to improve awareness of the current CINV prophylaxis CPG and to facilitate CPG-consistent CINV prophylaxis.
authors: Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
authors: Priya
authors: P
authors: Patel
authors: Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada.
authors: Paula D
authors: PD
authors: Robinson
authors: Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, Connecticut.|Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut.
authors: Andrea
authors: A
authors: Orsey
authors: Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.|Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Jason L
authors: JL
authors: Freedman
authors: Division of Pediatric Hematology/Oncology, University of Texas Health Science Centre at San Antonio, San Antonio, Texas.
authors: Anne-Marie
authors: AM
authors: Langevin
authors: Division of Hematology/Oncology, Department of Pediatrics, Washington University, St. Louis, Missouri.
authors: Debbie
authors: D
authors: Woods
authors: Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.|Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Lillian
authors: L
authors: Sung
authors: Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.|Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.|Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors: L Lee
authors: LL
authors: Dupuis
mesh_terms: D000328:Adult; D000932:Antiemetics / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D009369:Neoplasms / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D000932:Antiemetics
keywords: antiemetic; chemotherapy-induced vomiting; nausea; pediatrics; supportive care; vomiting