Urejenost s kemoterapijo povzročene slabosti in bruhanja pri bolnikih z gastrointestinalnimi tumorji : enoviti magistrski študijski program Farmacija

Barle, Rok (author), Vovk, Tomaž (mentor), Dobravc Verbič, Matej (co-mentor)

Številni rakavi bolniki doživijo slabost in bruhanje kot neželeni učinek kemoterapije. Neurejenost s kemoterapijo povzročene slabosti in bruhanja lahko poleg slabše kakovosti življenja vodi do slabšega sodelovanja pri zdravljenju in slabše urejenosti slabosti in bruhanja pri naslednjih ciklih kemoterapije. Namen raziskave je pridobiti informacije o stanju predpisovanja antiemetikov, urejenosti in vplivu napovednih dejavnikov na urejenost s kemoterapijo povzročene slabosti in bruhanja. Podatke o prejetih antiemetikih in kemoterapiji smo pridobili s pomočjo zdravstvene dokumentacije. Podatke o urejenosti slabosti in bruhanja v akutni (24 ur po kemoterapiji) in zakasnjeni (2–4 dni po kemoterapiji) fazi smo dobili s pomočjo vprašalnikov. Glede na stopnjo emetogenosti kemoterapijskega režima smo določili skladnost prejetih antiemetikov z uveljavljenimi priporočili za zdravljenje s kemoterapijo povzročene slabosti in bruhanja. Z binarno logistično regresijo smo vrednotili vpliv napovednih dejavnikov na urejenost s kemoterapijo povzročene slabosti in bruhanja. V študijo smo vključili 62 bolnikov (69,7 % vseh povabljenih). Ustrezne antiemetike pred kemoterapijo je prejelo 50 (80,6 %) bolnikov glede na postopek najvišje emetogenega citostatika in 8 (12,9 %) bolnikov glede na Heskethov postopek. Po kemoterapiji ni noben od bolnikov prejel antiemetikov skladno s smernicami. Akutna slabost in bruhanje sta v primerjavi z zakasnjeno bolje urejena. 46 (74,2 %) bolnikov je imelo urejeno slabost in bruhanje v akutni fazi in 39 (62.9 %) v zakasnjeni. Statistično značilni napovedni dejavniki za pojav slabosti in bruhanja v celotnem obdobju po kemoterapiji so ustrezno predpisani kortikosteroidi pred kemoterapijo (RO=9,025, p=0,019) in starost (RO=0,851, p=0,002). Zakasnjena slabost in bruhanje sta bila odvisna od starosti (RO=0,885, p=0,030) in akutne slabosti in bruhanja (RO=17,377, p=0,001). Večina bolnikov je prejela ustrezno antiemetično terapijo pred kemoterapijo, kar pa ne velja za antiemetično terapijo, prejeto po kemoterapiji. Ustreznejše predpisovanje antiemetikov bi se lahko odražalo v boljši urejenosti s kemoterapijo povzročene slabosti in bruhanja.

• Language: Slovenian
• Keywords: zdravljenje s kemoterapijo slabost bruhanje antiemetična terapija zakasnjena faza gastrointestinalni tumor
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: FFA - Faculty of Pharmacy
• Place of publishing: Ljubljana
• Publisher: [R. Barle]
• Year: 2016
• Number of pages: IX, 67 f.
• PID: 20.500.12556/RUL-120976
• UDC: 616.3-006:615.2(043.3)
• COBISS.SI-ID: 4264561
• Publication date in RUL: 28.09.2020

Secondary language

• Language: English
• Title: Control of chemotherapy-induced nausea and vomiting in patients with gastrointestinal tumours : Uniform Master's Study Programme Pharmacy

Abstract

During cancer treatment, many patients experience chemotherapy-induced nausea and vomiting which leads to lower quality of life and poorer adherence to subsequent chemotherapy cycles. Study aim was to assess antiemetic therapy prescribing and nausea and vomiting control in the acute (24 hours post-chemotherapy) and delayed phase (days 2–4 post-chemotherapy). Factors influencing chemotherapy-induced nausea and vomiting control were also determined. Information on antiemetic premedication was gathered from patient medical records. Data regarding antiemetic therapy post-discharge and nausea and vomiting control in both phases were obtained using patient questionnaires. Antiemetic therapy prescribing was compared with internal chemotherapy-induced nausea and vomiting prevention and control guidelines. Predictive factors for chemotherapy-induced nausea and vomiting control were evaluated using binary logistic regression. 62 patients were enrolled in the study. 50 (80.6 %) patients received adequate antiemetic premedication, regarding the procedure of the most emetogenic cytostatic drug and 8 (12.9 %) regarding Hesketh algorithm. In the acute phase, 46 (74.2 %) patients reported well-controlled nausea and vomiting. None of the patients was prescribed post-discharge antiemetic therapy as per guidelines. In the delayed phase, nausea and vomiting were more frequent: well-controlled and uncontrolled chemotherapy-induced nausea and vomiting were reported by 39 (62.9 %) and 23 (37.1 %) patients, respectively. Overall, statistically significant predictive factors for chemotherapy-induced nausea and vomiting control were appropriate prescription of corticosteroids (OR=9.025, p=0.019) and patient age (OR=0.851, p=0.002). Delayed nausea and vomiting control was dependent on age (OR=0.885, p=0.030) and acute nausea and vomiting control (OR=17.377, p=0.001). Majority of the patients were prescribed adequate antiemetic therapy for the acute but not for the delayed phase, which may have resulted in more patients experiencing delayed nausea and vomiting.

• Keywords: chemotherapy-induced nausea and vomiting control guidelines antiemetic therapy acute phase delayed phase gastrointestinal tumour