Abstract 583P
Background
NK-1 receptor antagonist aprepitant orally is given over 3 days in HEC and MEC regimens. The practical use of aprepitant in a day to day real world setting from patient's point of view has not been described. This study aims to identify various errors that may occur with contemporary aprepitant use.
Methods
Single institutional, questionnaire based cross sectional study done in June 2024. Patients receiving single day HEC and MEC regimens were included. Only prescriptions as per anti-emetic protocols as per the MASCC/ESMO guidelines were included. Patients were to have received a minimum of 2 cycles of the same regimen previously. The responses of patients were corroborated independently with caregiver.
Results
50 patients aged ranging 32-84 years (median 61 years), 32 patients being males. The GI tract was most common site of primary in 22 (44.%) followed by breast 11(22.2) and gyneacological sites in 18%. 53.33% were administered HEC and 46.6% MEC regimens. 24% patients had received only upto primary education, 52% secondary education and only 24% were graduates .46% of patients and 38% of caregivers did not know the reason why aprepitant was being prescribed. Aprepitant was missed in 5 patients on D1, 9 patients on D2 and D3. In 16(32%) of patients, aprepitant was administered <1 hour before start of chemotherapy. 14 (28%) of patients felt that nausea and vomiting was a significant problem during chemotherapy and 6( 12%) had vomiting during administration of chemotherapy. 4 (8%) patients had emergency visits specifically for severe nausea or vomiting.
Conclusions
In this reflecting real world practices in a busy tertiary cancer centre, GI cancers predominated (44%). Majority (76%) had only basic schooling education and nearly half of patients were unaware of reason for prescription of aprepitant. Medication errors in form of missed aprepitant doses and inappropriate administration was seen in 1/3 of patients. Though administration of aprepitant provides 100% control of nausea and vomiting, real world practice data suggests otherwise. With narrowing gap in the costs of oral and i.v formulations of aprepitant, the latter must be preferred in HEC and MEC regimens to improve quality of chemotherapy delivery.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.