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- Title
Antiemetic prescribing practices using a computerized physician order entry system.
- Authors
Kadakia, Kunal C.; Leal, Alexis D.; Seisler, Drew K.; Qin, Rui; Fee-Schroeder, Kelliann C.; Grendahl, Darryl C.; Sorgatz, Kristine M.; Loprinzi, Charles L.
- Abstract
Purpose: Adherence to guideline-consistent chemotherapy-induced nausea and vomiting (CINV) prophylaxis is suboptimal. The primary aim of this study was to evaluate the magnitude of compliance to institutional guideline-directed antiemetic prophylaxis using a computerized physician order entry system at a single tertiary care institution. A nurse survey was also performed to evaluate how oncology practices, within a cooperative group, managed clinician orders for the prevention of CINV. Methods: The electronic medical records of 100 consecutive patients were evaluated. The primary endpoint was the incidence of compliance to provide all aspects of scheduled institutional guideline-directed antiemetic prophylaxis for acute (day 1) and delayed (days 2–4) CINV. A descriptive analysis was performed on the convenience sample. Logistic regression was completed to determine the predictors of noncompliance. Results: The incidence of compliance on days 1–4 was 94 %. Half of the noncompliant events (three of six, 50 %) occurred on day 1 alone and involved patients receiving low-emetogenic chemotherapy. There was a high degree of compliance to institutional guidelines for the treatment of delayed CINV (97 %). Patients receiving minimally emetogenic and moderately emetogenic chemotherapy ( N = 70) were observed to be 100 % compliant. Patients receiving doxorubicin/cyclophosphamide were numerically less likely to receive institutional guidelines, compared to patients receiving other chemotherapy regimens (OR, 0.24 (0.04, 1.36), p value, 0.05). The nurse survey suggested significant variability amongst the involved institutions with regards to antiemetic prescribing practices. Conclusions: Computerized physician order entry is associated with impressive adherence to clinician-prescribing practices, according to institutional guidelines, for acute and delayed CINV.
- Subjects
ANTIEMETICS; DRUG prescribing; PHYSICIAN practice patterns; ORDER entry; CANCER chemotherapy; CANCER patients; THERAPEUTICS
- Publication
Supportive Care in Cancer, 2014, Vol 22, Issue 1, p217
- ISSN
0941-4355
- Publication type
Article
- DOI
10.1007/s00520-013-1969-2