Chemotherapy-induced nausea and vomiting prophylaxis in pediatric patients at a teaching hospital: assessment of adherence to guidelines

Abstract

Aims: Describing the adherence rate of antiemetic prophylaxis in pediatric patients using antineoplastic agents and possible associated factors. Methods: It is a retrospective cross-sectional study, which took place in a teaching hospital at Belo Horizonte. There were included pediatric patients that received chemotherapy at the hospital from January to June, 2022. The demographic, clinical and pharmacotherapeutic data were collected from physicians’ prescriptions and patients’ charts. Descriptive analysis was performed and the results were expressed by absolute and relative frequency for categorical variables and by measures of central tendency and dispersion for numeral variables. Univariate analysis was done in order to assess the association between chemotherapy induced nausea and vomiting and exposure variables. It was calculated through Pearson’s chi-square test. It was considered statistically significant a p-value less than 0,05. Results: It was observed that the prescription practice was closer to recommendations made by guidelines of American Society of Clinical Oncology and Multinational Association of Supportive Care in Cancer | European Society of Medical Oncology with 62% of adherence, meanwhile Pediatric Oncology Group of Ontario had 4,6% of concordance. Underuse of antiemetics was the principal reason for discordance. In particular the lack of dexamethasone prescription. It was identified statistically significance association between nausea and vomiting registers and vincristine and cyclophosphamide use. Conclusions: This study detected high adherence to the American Society of Clinical Oncology and Multinational Association of Supportive Care in Cancer | European Society of Medical Oncology guidelines, even though, the number of observed nausea and vomiting events flag up a potential failure in the antiemetic prophylaxis. The associative analyses between nausea and vomiting registers and vincristine and cyclophosphamide use were statistically significant.