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Poster display session

3895 - Evaluation of Antiemetic Practices for Prevention of Chemotherapy-induced Nausea and Vomiting (CINV): Results of a European Oncology Nurse Survey


10 Sep 2017


Poster display session


Supportive Care and Symptom Management




Annals of Oncology (2017) 28 (suppl_5): v543-v567. 10.1093/annonc/mdx388


P. DIELENSEGER1, S. Borjeson2, C. Vidall3, A. Young4, P. Jahn5

Author affiliations

  • 1 Early Drug Development, Gustave Roussy Institute of Oncology, 94800 - Villejuif/FR
  • 2 Department Of Medical And Health Sciences, Division Of Nursing Science, Linköping University, Linköping/SE
  • 3 Nursing And Governance, Alcura UK Ltd, Northampton/GB
  • 4 Cancer Research Centre, University Hospitals Coventry and Warwickshire, Coventry/GB
  • 5 Nursing Research Unit, University Hospital Halle (Saale), Halle/DE


Abstract 3895


Preventing CINV in most patients is possible when guideline-recommended prophylactic antiemetics are utilized. Because oncology nurses play a critical role in risk assessment and management of CINV, a survey of European nurses was conducted to evaluate antiemetic practices, determine awareness of and adherence to current guideline recommendations, and explore barriers to adherence.


Between March 2016 and March 2017, 212 oncology nurses in 16 European countries completed a 20-question online survey.


Respondents had 15 years (median) experience as an oncology nurse and most were able to suggest or prescribe antiemetics. Most (n = 169, 80%) worked in the public not-for-profit hospital setting, seeing both in- and outpatients (n = 107, 50%). While nurses were most familiar with ASCO (n = 97, 46%) and MASCC/ESMO (n = 84, 40%) guidelines, individual institution guidelines were used most (n = 99, 47%). Key discrepancies between antiemetic use and guideline recommendations were: i) underutilization of NK1RAs, 5-HT3RAs and a steroid on Day 1 in the HEC setting and ii) high use of 5-HT3RAs during days 2-5 when guidelines recommend a steroid (Table 1). Metoclopramide use (not guideline recommended) was also high, with ∼30% and ∼50% of nurses reporting usage for acute and delayed phases, respectively, for both HEC and MEC settings. The most common barrier to the use of guideline-recommended agents was reported as physician preference (n = 84, 40%). Product cost and formulary inclusion also played a role. The 2 most common challenges in managing CINV were “controlling nausea and vomiting in the delayed phase” (n = 135, 64%) and “reducing the impact of CINV on patients’ quality-of-life” (n = 130, 61%).rnTable:

1552P Antiemetic Utilization - European Nurse Survey

SettingAntiemetic ClassAntiemetics Utilized n (% respondents)
Acute Phase (0-24 h)Delayed Phase (25-120 h)
HEC5-HT3 RA NK1 RA NEPA Steroid (eg, DEX) Phenothiazine Benzodiazepine Antipsychotic Metoclopramide171 (81%) 130 (61%) 48 (23%) 173 (82%) 1 (0%) 35 (17%) 10 (5%) 63 (30%)105 (50%) 92 (43%) 23 (11%) 133 (63%) 12 (6%) 25 (12%) 19 (9%) 103 (49%)
MEC5-HT3 RA NK1 RA NEPA Steroid (eg, DEX) Phenothiazine Benzodiazepine Antipsychotic Metoclopramide183 (86%) 44 (21%) 17 (8%) 164 (77%) 3 (1%) 14 (7%) 5 (2%) 67 (32%)100 (47%) 38 (18%) 19 (9%) 122 (58%) 10 (5%) 15 (7%) 13 (6%) 108 (51%)

HEC: highly emetogenic, MEC: moderately emetogenic, DEX: dexamethasone, NEPA: fixed combination of netupitant/palonosetron



This survey highlights many opportunities to improve utilization of guideline-recommended antiemetics, thereby optimizing prevention of CINV and quality-of-life for patients receiving emetogenic chemotherapy.

Clinical trial identification

Legal entity responsible for the study

Helsinn Healthcare SA


Helsinn Healthcare, SA


P. Dielenseger: Member of advisory boards of Helsinn, Bayer Healthcare, Pfizer, Shire, Tesaro, Janssen, and BMS A. Young: Received honorarium from MSD (advisory board and presentations given), Helsinn (advisory boards) and Chugai (presentation given). P. Jahn: Support includes travel support: Helsinn (2014); Current consulting or advisory role: Bristol-Myers Squibb, Chugai, Norgine, and Clinigen; Clinical Research Fund by Chugai. All other authors have declared no conflicts of interest.

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