Use of antiemetics in the management of chemotherapy-related nausea and vomiting in current UK practice

Purpose The main aim of the present study was to assess antiemetic prescriptions used during chemotherapy and identify if these are in agreement with internationally agreed consensus guidelines (MASCC/ASCO). Methods A web-based survey in the UK was carried out collecting data through a 32-item questionnaire using a snowball sampling technique and the email lists of two large oncology societies in the country. Results The participants were 154 oncologists and oncology nurse prescribers. Data showed a great variability in antiemetic prescriptions used, most not been in accordance with MASCC/ASCO consensus guidelines. The variability was also reflected in the doses of antiemetics used. Overall, clinicians undertreated patients receiving highly emetogenic chemotherapy and overtreated patients receiving low and minimally emetogenic chemotherapy. Eight of ten clinicians, however, prescribed antiemetics in accordancewith consensus guidelines in moderately emetogenic chemotherapy. There was more agreement between clinicians and guidelines for acute nausea/vomiting and less for delayed symptoms. The uptake of MASCC/ASCO guidelines was minimal. Conclusions The low level of agreement between actual clinical practice and evidence-based consensus guidelines may be one of the reasons for the considerable incidence of chemotherapy-related nausea and vomiting. There is a need to utilise consensus guidelines more widely and educate clinicians on this aspect of supportive care.