化疗所致恶心呕吐预防方案的止吐指南依从性评价

Adherence to clinical guidelines for prophylaxis of chemotherapy induced nausea and vomiting

目的:探讨化疗所致恶心呕吐预防方案的止吐指南依从性,为临床合理用药提供依据。方法:回顾某院2015年5月1日-2017年5月1日肿瘤化疗患者的预防止吐方案应用情况并进行止吐指南依从性评价,共纳入161例患者。结果:单日化疗组(n=137)中,预防急性和延迟性CINV的指南依从率分别为45%和7%;多日化疗组(n=23)的止吐指南依从率为48%。指南不依从情况主要表现为止吐方案不依从(止吐方案过强、止吐方案过弱和重复用药)、剂量不适宜(少)和疗程不适宜(短)。结论:该院预防肿瘤化疗所致恶心呕吐的止吐指南依从性较低,且单日化疗的止吐指南依从性低于多日化疗,延迟性CINV的止吐指南依从性低于急性CINV。应加强管理化疗患者预防止吐方案的合理使用,从而提高化疗患者的生活质量,保障化疗的顺利进行。

OBJECTIVE To assess the adherence to the antiemetic clinical guidelines for prophylaxis of chemotherapy induced nausea and vomiting（CINV）at our hospital,and provide a reference for rational clinical drug administration.METHODS Totally 161 chemotherapy patients were included from May 1,2015 to May 1,2017.Antiemetic prescribing patterns and their consistency with antiemetic clinical guidelines were assessed retrospectively.RESULTS Overall,in the single day chemotherapy group,prophylaxis of acute and delayed CINV was compliant in 62 of 137（45%）patients and 10（7%）patients,respectively.In the multiday chemotherapy group,prophylaxis of CINV was compliant in 11 of 23（48%）patients.The non-compliance mainly included incorrect use of prophylaxis of CINV（overuse of antiemetic strategy,underuse of antiemetic strategy and repeated medication）,incorrect dose of antiemetic（less）and incorrect course of treatment（less）.CONCLUSION The adherence is poor for clinical guidelines for prophylaxis of CINV in our hospital.The adherence is inferior in single day chemotherapy to multiday chemotherapy,or in acute CINV to that of delayed CINV.The management of antiemetic use should be enhanced to improve the quality of life,and ensure the smooth progress of chemotherapy.