Helping patients discuss CINV management: development of a Patient Charter.

Annie Young,Pascale Dielenseger,Sue Sharp,Elaine Lennan,Eileen O'Donovan,Philippa Jones,Alison Whiteford,Dolores Fernandez Perez,Paz Fernandez Ortega,Lilian Wiles

doi:10.3332/ecancer.2013.296

Abstract

In April 2012, an Expert Group of specialist cancer nurses working in a variety of settings (e.g. chemotherapy delivery, chemotherapy service design, research, nurse leadership and patient information/advocacy) participated in telephone/web-based meetings, with the aim of sharing current experience of chemotherapy-induced nausea and vomiting (CINV) management, and reaching a consensus on the development of a Patient Charter, designed to help patients understand CINV management, and setting out key questions they may wish to ask their healthcare professionals.

Highlights

At the outset of chemotherapy, patients frequently cite the risk of nausea and/or vomiting as one of their biggest fears [1]
The risk of chemotherapy-induced nausea and vomiting (CINV) varies according to the chemotherapy agents delivered
This article describes the outcomes of a telephone/web-based nurse consensus meeting convened to share experience and views on current management of CINV, and to agree on the formulation of a Patient Charter, designed to inform chemotherapy recipients about CINV management, and help them to discuss preventative and interventional strategies with their oncology healthcare professionals

Summary

Introduction

At the outset of chemotherapy, patients frequently cite the risk of nausea and/or vomiting as one of their biggest fears [1]. A full assessment of an individual’s risk of CINV requires examination of published evidence on the emetogenic status of the chemotherapy agents used, bearing in mind the dose, delivery method, and the effect of multiple-drug regimens, plus the patient’s history Based on this information, an appropriate antiemesis strategy can be chosen by a multidisciplinary team of physicians, nurses and pharmacists with experience in cancer care [7]. Evidence based guidelines on the management of CINV have been published (and are regularly updated) by the Multinational Association of Supportive Care in Cancer in association with the European Society of Medical Oncology (MASCC/ESMO), and by the National Comprehensive Cancer Network (NCCN), and the American Society of Clinical Oncology (ASCO) [9,10,11] All of these documents highlight the key role of CINV prophylaxis, administered from chemotherapy cycle 1 before any symptoms of nausea or vomiting appear, for patients deemed to be at high or moderate risk. This article describes the outcomes of a telephone/web-based nurse consensus meeting convened to share experience and views on current management of CINV, and to agree on the formulation of a Patient Charter, designed to inform chemotherapy recipients about CINV management, and help them to discuss preventative and interventional strategies with their oncology healthcare professionals

Methodology

Findings

Conclusion