Prophylactic use of antiemetics for prevention of opioid-induced nausea and vomiting: a survey about Italian physicians' practice.

Purpose: Antiemetics are being used both for the treatment and prophylaxis of opioid-induced nausea and vomiting (OINV) in clinical practice, despite the lack of evidence for the prophylactic benefit. Studies among Japanese physicians demonstrated over 80% prescribe antiemetics, with neuroleptic ant...

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Publicado en:Supportive Care in Cancer Vol. 27; no. 9; pp. 3531 - 3536
Autores principales: Giusti, Raffaele, Mazzotta, Marco, Filetti, Marco, Daniele, Gennaro, Tsukuura, Hiroaki, Ficorella, Corrado, Porzio, Giampiero, Marchetti, Paolo, Verna, Lucilla
Formato: questionnaire/scale research tables/charts Journal Article
Publicado: Springer Nature Sep2019
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Prophylactic use of antiemetics for prevention of opioid-induced nausea and vomiting: a survey about Italian physicians' practice.
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          Giusti, Raffaele
          Mazzotta, Marco
          Filetti, Marco
          Daniele, Gennaro
          Tsukuura, Hiroaki
          Ficorella, Corrado
          Porzio, Giampiero
          Marchetti, Paolo
          Verna, Lucilla
        affil: Medical Oncology Unit, Azienda Ospedaliero Universitaria Sant'Andrea, Via di Grottarossa 1035-39, 00189, Rome, Italy
      sug:
        subj:
          Analgesics, Opioid Adverse Effects
          Vomiting Prevention and Control
          Adrenal Cortex Hormones Therapeutic Use
          Serotonin Antagonists Therapeutic Use
          Antiemetics Therapeutic Use
          Antipsychotic Agents Therapeutic Use
          Nausea Prevention and Control
          Vomiting Chemically Induced
          Nausea Drug Therapy
          Dopamine Antagonists Therapeutic Use
          Physicians
          Prospective Studies
          Adult
          Analgesics, Opioid Therapeutic Use
          Nausea Chemically Induced
          Metoclopramide Therapeutic Use
          Vomiting Drug Therapy
          Language
          Cross Sectional Studies
          Female
          Male
          Italy
          Human
          Adult: 19-44 years
          Female
          Male
      ab: Purpose: Antiemetics are being used both for the treatment and prophylaxis of opioid-induced nausea and vomiting (OINV) in clinical practice, despite the lack of evidence for the prophylactic benefit. Studies among Japanese physicians demonstrated over 80% prescribe antiemetics, with neuroleptic antipsychotics as the most commonly prescribed drugs. Our objective was to elucidate the current scenario of the prophylactic use of antiemetics for OINV among Italian physicians.Methods: We conducted a web-based cross-sectional national survey. All the invited participants received an e-mail with an 11-item electronic questionnaire accessible through a direct link. Anonymity was guaranteed. According to the exploratory intent of the survey, we did not predefine any formal statistical hypothesis. Associations between variables were tested by the Pearson chi-square or the Fisher exact test.Results: From January to March 2017, 112 completed the electronic questionnaire (112/256, overall response rate, 43.7%). Nearly half of the participants were oncologists (54; 48.2%). Sixty-one (54.4%) physicians worked in palliative care units. About 45% of the interviewed prescribed prophylactic antiemetics at the beginning of opioid prescription. The most commonly chosen drugs for this purpose were prokinetics such as metoclopramide and domperidone (84%), followed by 5-HT3 antagonists (8%), neuroleptic antipsychotics (6%), and corticosteroids (2%). Ninety-one physicians (81%) declared to prescribe antiemetics at the occurrence of OINV, mainly prokinetics (N = 70; 77%).Conclusion: Italian physicians do not commonly prescribe prophylactic antiemetics for OINV. Unlike previously reported data, dopamine antagonists resulted the most commonly prescribed drugs. Prospective clinical trials are necessary to evaluate the real efficacy of this practice.
      pubtype: Academic Journal
      doctype:
        questionnaire/scale
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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