Assessment of Chemotherapy-Induced Nausea and Vomiting in Pediatrics:
Adequacy of Control and Adherence to Guidelines
Abstract
Background: Chemotherapy-induced nausea and vomiting
(CINV) is one of the most common side effects of chemotherapy in
patients. Although sufficient evidence regarding its assessment and
treatment in adults exists, CINV is more complicated in children. There
are established guidelines for its prevention and treatment endorsed by
several reputable organizations; however, their adherence varies between
institutions. Therefore, this study aimed to assess the incidence and
severity of CINV in pediatric patients receiving any form of
chemotherapy in the acute and delayed phases and evaluated our
institution’s adherence to published guidelines endorsed by the
Pediatric Oncology Group of Ontario. Procedure: This was
a prospective longitudinal single-center study. A structured assessment
was administered twice to patients or their caregivers during the acute
and delayed phases. Baxter Animated Retching Faces scale was used.
Results: A total of 186 patients completed 236 surveys,
including those for acute and delayed phases. Incidence of acute nausea
was reported in 33% patients of both phases, while vomiting was
observed in 20.3% and 18.8% of the acute and delayed phases,
respectively. A total of 31% patients met the criteria for proper
adherence in case of prescribed appropriate antiemetic agent(s)/class
irrespective of the dose. Conclusion: CINV is a major
side effect among children who receive high and moderate emetogenic
chemotherapy compared to those receiving minimal and low regimens.
Despite the low rate of adherence to the guidelines, the incidence and
severity of CINV reported in our study were acceptable and indicate good
clinical practice. Further research should seek strategies to better
implement and standardize these guidelines.