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.

Prophylactic use of antiemetics for prevention of opioid-induced nausea and vomiting. a survey about Italian physicians’ practice / Giusti, R.; Mazzotta, M.; Filetti, M.; Daniele, G.; Tsukuura, H.; Ficorella, C.; Porzio, G.; Marchetti, P.; Verna, L.. - In: SUPPORTIVE CARE IN CANCER. - ISSN 0941-4355. - 27:9(2019), pp. 3531-3535. [10.1007/s00520-019-4663-1]

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

Mazzotta M.;Filetti M.;Marchetti P.;
2019

Abstract

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.
2019
antiemetics; cancer pain; oinv; opioid-induced nausea and vomiting; prophylaxis; adrenal cortex hormones; adult; analgesics, opioid; antiemetics; antipsychotic agents; cross-sectional studies; domperidone; dopamine antagonists; female; humans; italy; language; male; metoclopramide; nausea; physicians; practice patterns, physicians'; prospective studies; serotonin 5-ht3 receptor antagonists; surveys and questionnaires; vomiting
01 Pubblicazione su rivista::01a Articolo in rivista
Prophylactic use of antiemetics for prevention of opioid-induced nausea and vomiting. a survey about Italian physicians’ practice / Giusti, R.; Mazzotta, M.; Filetti, M.; Daniele, G.; Tsukuura, H.; Ficorella, C.; Porzio, G.; Marchetti, P.; Verna, L.. - In: SUPPORTIVE CARE IN CANCER. - ISSN 0941-4355. - 27:9(2019), pp. 3531-3535. [10.1007/s00520-019-4663-1]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1484774
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