Abstract
Background: Nausea and vomiting induced by chemotherapy is one of the most feared side effects of chemotherapy that affect patients’ quality of life and may lead to discontinuation of chemotherapy cycles. Adherence to antiemetics guidelines such as NCCN antiemetics guidelines significantly improve the quality of treatment provided to patients while minimizing the time and money spent on each individual case.
 Aim: Assessment of the current practice adherence of physicians to NCCN antiemesis guidelines.
 Method: the study is an observational cross-sectional study conducted in three oncology centers in the Iraqi province of Karbala. The study included twenty oncologists who agree to participate in the survey.
 Results: Seventy percent of participants oncologists follow NCCN antiemetics guidelines, while thirty percent do not. The mean patient related risk score for Imam Al-Hussein Oncology Center, Warith International Cancer Institute, and Al-Imam Al-Hasan Al-Mujtaba Hospital was 13.5, 12.4, 14.7 respectively.
 Conclusion: The current study demonstrates the knowledge and practices of participating oncologists regarding nausea and vomiting caused by chemotherapy across various oncology centers. In addition, there are a number of obstacles that make following antiemetics guidelines difficult or inconvenient, such as increased cost, a lack of awareness about antiemetics guidelines, and guidelines that are difficult or inconvenient to use.
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