Congress Abstracts 2006

152

ONCOLOGY NURSE SURVEY OF 5-HT3 RECEPTOR ANTAGONISTS USE IN CLINICAL PRACTICE. Barbara Baum, RN, BSN, OCN^®, Creative Cancer Concepts, Inc., Rockwall, TX; Jason Rothaermel, RN, BSN, OCN^®, Cleveland Clinic Foundation, Cleveland, OH; Jill Shear, RN, BSN, and Beth Ramer, RN, MSN, MGI Pharma, Inc., Bloomington, MN; and Elaine DeMeyer, RN, MSN, AOCN^®, Creative Cancer Concepts, Inc., Rockwall, TX.

Despite established antiemetic guidelines, patients experiencing chemotherapy induced nausea and vomiting (CINV) are managed inconsistently. The incidence of CINV has been reported in as much as 80% of individuals receiving chemotherapy. CINV has a negative effect on all aspects of the patient's life, including the potential for electrolyte imbalances, malnutrition, dehydration, dose reductions and dose delays. Over the past decade several new antiemetic agents have emerged along with published guidelines and a growing body of CINV research. Consequently, it has become necessary to determine the level of compliance to these guidelines in practice. Oncology nurses have a unique role in promoting evidence based practice and influencing antiemetic prescribing patterns.

The purpose of this abstract is to describe the practice patterns and awareness of 5-HT₃ antiemetics for both acute and delayed CINV.

During the 2005 ONS Congress, 2068 nurses participated in a survey to assess their awareness of 5-HT₃ antagonists and practice patterns. The majority surveyed (42.8%) worked in-patient, 30% outpatient, 21.5% in a private office setting, with 5.8% in academia.

The survey indicated only 23.1% regularly use a second generation 5-HT₃ antagonist such as palonosetron as front line antiemetic therapy. Almost two-thirds, (60.7%) had limited or no experience with palonosetron. Of those experienced with palonosetron, 47.1% stated no additional 5-HT₃ antagonists are used. When asked about the use of first generation 5-HT₃ antagonists (dolasetron, granisetron, ondansetron) for primary therapy, 77.1 % regularly use additional 5-HT₃ antagonists for follow-up therapy. Yet according to recently published Community Clinical Oncology Program (CCOP) data, short-acting 5-HT₃ antagonists were no better than prochlorperazine for follow-up therapy. Additionally, 68.8% incorporate dexamethasone in follow-up therapy.

There is a great need for increased familiarity with palonosetron, antiemetic guidelines and CINV research. Current guidelines recommend a 5-HT₃ antagonist plus dexamethasone as frontline therapy, with dexamethasone for follow-up, as the preferred strategy for prevention of CINV. Palonosetron has demonstrated through numerous clinical trials, to have the highest level of efficacy amongst the 5-HT₃ antagonists available. This survey emphasizes the need for nursing education and understanding of available antiemetic medications for optimal patient outcomes.