Evaluation of antiemetic practices for prevention of chemotherapy-induced nausea and vomiting (CINV): results of a European oncology nurse survey.

INTRODUCTION: Preventing CINV is possible when guideline-recommended antiemetics are used. Because oncology nurses play a critical role in risk assessment and management of CINV, a survey of European nurses was conducted to evaluate antiemetic practices, assess awareness of and adherence to current guideline recommendations, and explore barriers to adherence.

METHODS: From March 2016 to Feb 2017, 212 oncology nurses in 16 European countries completed a 20-question online survey.

RESULTS: Respondents had 15-year (median) oncology nursing experience, and most (75%) were able to suggest or prescribe antiemetics. Most (80%) worked in the public not-for-profit hospital setting. Guideline awareness was generally low with nurses most familiar with ASCO (46%) and MASCC/ESMO (40%) guidelines; individual institution guidelines were most commonly used (47%). Key discrepancies between reported antiemetic use and guideline recommendations in the highly emetogenic chemotherapy (HEC) setting were underutilization of the recommended NK1 RA + 5-HT3 RA + steroid combination on day 1 (55%) and high use of 5-HT3 RAs (50%) on days 2-5 when a steroid (63% use) should be used. Metoclopramide use was high in both HEC and moderately emetogenic settings, with ~ 30% and ~ 50% reporting use on day 1 and days 2-5, respectively. The most common reported barrier to use of guideline-recommended agents was physician preference (40%). The most common challenges in managing CINV were "controlling nausea/vomiting in the delayed phase" (64%) and "reducing the impact of CINV on patients' quality-of-life" (61%).

CONCLUSIONS: This survey highlights opportunities to improve utilization of guideline-recommended antiemetics, thereby optimizing prevention of CINV and QoL for patients receiving emetogenic chemotherapy.