Antiemetic prescribing practices using a computerized physician order entry system

Kunal C. Kadakia, Alexis D. Leal, Drew K. Seisler, Rui Qin, Kelliann C. Fee-Schroeder, Darryl C. Grendahl, Kristine M. Sorgatz, Charles L. Loprinzi

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Purpose: Adherence to guideline-consistent chemotherapy-induced nausea and vomiting (CINV) prophylaxis is suboptimal. The primary aim of this study was to evaluate the magnitude of compliance to institutional guideline-directed antiemetic prophylaxis using a computerized physician order entry system at a single tertiary care institution. A nurse survey was also performed to evaluate how oncology practices, within a cooperative group, managed clinician orders for the prevention of CINV. Methods: The electronic medical records of 100 consecutive patients were evaluated. The primary endpoint was the incidence of compliance to provide all aspects of scheduled institutional guideline-directed antiemetic prophylaxis for acute (day 1) and delayed (days 2-4) CINV. A descriptive analysis was performed on the convenience sample. Logistic regression was completed to determine the predictors of noncompliance. Results: The incidence of compliance on days 1-4 was 94 %. Half of the noncompliant events (three of six, 50 %) occurred on day 1 alone and involved patients receiving low-emetogenic chemotherapy. There was a high degree of compliance to institutional guidelines for the treatment of delayed CINV (97 %). Patients receiving minimally emetogenic and moderately emetogenic chemotherapy (N = 70) were observed to be 100 % compliant. Patients receiving doxorubicin/ cyclophosphamide were numerically less likely to receive institutional guidelines, compared to patients receiving other chemotherapy regimens (OR, 0.24 (0.04, 1.36), p value, 0.05). The nurse survey suggested significant variability amongst the involved institutions with regards to antiemetic prescribing practices. Conclusions: Computerized physician order entry is associated with impressive adherence to clinician-prescribing practices, according to institutional guidelines, for acute and delayed CINV.

Original languageEnglish (US)
Pages (from-to)217-223
Number of pages7
JournalSupportive Care in Cancer
Volume22
Issue number1
DOIs
StatePublished - Jan 2014

Keywords

  • Acute CINV
  • Antiemetics
  • Chemotherapy-induced nausea and vomiting
  • Computerized physician order entry
  • Delayed CINV

ASJC Scopus subject areas

  • Oncology

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    Kadakia, K. C., Leal, A. D., Seisler, D. K., Qin, R., Fee-Schroeder, K. C., Grendahl, D. C., Sorgatz, K. M., & Loprinzi, C. L. (2014). Antiemetic prescribing practices using a computerized physician order entry system. Supportive Care in Cancer, 22(1), 217-223. https://doi.org/10.1007/s00520-013-1969-2