
Center for Advanced Practice
Title
Improving Guideline-Congruent Care for Chemotherapy-Induced Nausea and Vomiting Prophylaxis in Pediatric Oncology Patients.
Publication Title
JCO Oncol Pract
Document Type
Article
PubMed ID
34705478
Abstract
PURPOSE: Chemotherapy-induced nausea and vomiting (CINV) is a very common side effect of pediatric cancer therapy. High-quality, evidence-based, pediatric-specific guidelines for prophylaxis and treatment of CINV are available. At many centers, guideline-concordant care is uncommon. We formed a multidisciplinary quality improvement team to implement guideline-concordant care for CINV prophylaxis at our center. We present the results following the first year of our interventions.
METHODS: We planned and implemented a multipronged approach in three key phases: (1) developing and publishing an acute CINV prophylaxis pathway, (2) education of providers, and (3) updating the computerized provider order entry system. We used iterative, sequential Plan-Do-Study-Act cycles and behavioral economic strategies to improve adherence to guideline-concordant CINV prophylaxis. We focused on aprepitant usage as a key area for improvement.
RESULTS: At the beginning of the study period, < 50% of patients were receiving guideline-concordant CINV prophylaxis and < 15% of eligible patients were receiving aprepitant. After 1 year, more than 60% of patients were receiving guideline-concordant care and 50% of eligible patients were receiving aprepitant.
CONCLUSION: We describe the development and implementation of a standardized pathway for prevention of acute CINV in pediatric oncology patients. With a multidisciplinary, multifaceted approach, we demonstrate significant improvements to guideline-congruent CINV prophylaxis.
Keywords
Antiemetics, Antineoplastic Agents, Aprepitant, Child, Nausea, Neoplasms, Vomiting, Pediatric Oncology, Chemotherapy
DOI
10.1200/OP.21.00476
Publication Date
3-1-2022
Citation
Diorio, C., Vardaro, J., Wei, Y., Mauro, J., Croy, C., Oranges, K., Flanagan, L., Reilly, A., Bailey, L., Jubelirer, T., Elgarten, C., & Freedman, J. (2022). Improving Guideline-Congruent Care for Chemotherapy-Induced Nausea and Vomiting Prophylaxis in Pediatric Oncology Patients.. JCO Oncol Pract, 18 (3), 412-412. https://doi.org/10.1200/OP.21.00476