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Guideline for the Prevention of Acute Nausea and Vomiting Due to Antineoplastic Medication in Pediatric Cancer Patients

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Guideline for the Prevention of Acute Nausea and Vomiting Due to Antineoplastic Medication in Pediatric Cancer Patients Guideline for the Prevention of Acute Nausea and Vomiting due to Antineoplastic Medication in Pediatric Cancer Patients The POGO Antineoplastic–induced Nausea and Vomiting Guideline Development Panel: L. Lee Dupuis MScPhm, ACPR, FCSHP Sabrina Boodhan BScPhm, ACPR Mark Holdsworth PharmD, BCOP Paula D. Robinson MD, MSc Richard Hain MD Carol Portwine MD, FRCPC, PhD Erin O’Shaughnessy RN, MScN, CPHON Lillian Sung MD, PhD Recommended citation: Dupuis LL, Boodhan S, Holdsworth M, Robinson PD, Hain R, Portwine C, O’Shaughnessy E and Sung L. Guideline for the Prevention of Acute Nausea and Vomiting due to Antineoplastic Medication in Pediatric Cancer Patients. Pediatric Oncology Group of Ontario; Toronto. 2012. 1 Version date: February 28, 2013 The Pediatric Oncology Group of Ontario (POGO) Guideline for the Prevention of Acute Nausea and Vomiting due to Antineoplastic Medication in Pediatric Cancer Patients was developed by health care professionals using evidence-based or best practice references available at the time of its creation. The content of the guideline will change since it will be reviewed and revised on a periodic basis. Care has been taken to ensure accuracy of the information. However, every health care professional using this guideline is responsible for providing care according to their best professional judgement and the policies and standards in place at their own institution. OVERVIEW OF MATERIAL Guideline release date: August, 2012 Status: Adapted, revised and updated Sources: Print copies available through the POGO office: 480 University Avenue, Suite 1014 Toronto, ON, CANADA M5G 1V2 Phone: 416-592-1232 Toll free: 1-855-FOR-POGO (367-7646) Electronic sources available on the POGO website: http://www.pogo.ca/healthcare/practiceguidelines/ Adapters: POGO Antineoplastic-induced Nausea and Vomiting Guideline Development Panel Source guidelines: This guideline has been broadly adapted with permission from the following two source guidelines: (1) The “Antiemetics: American Society of Clinical Oncology Clinical Practice Guideline Update” (Basch et al, 2011). The American Society of Clinical Oncology is not responsible in any way for the adaptation. (2) The Oncology Nursing Society guideline "Putting evidence into practice: Evidence-based interventions to prevent, manage, and treat chemotherapy- induced nausea and vomiting" (Tipton et al, 2007). The Oncology Nursing Society is not responsible in any way for the adaptation. 2 Version date: February 28, 2013 Table of Contents Overview of Material ........................................................................................................................................... 2 Summary of Recommendations ........................................................................................................................ 6 Glossary ............................................................................................................................................................. 10 Introduction ....................................................................................................................................................... 11 Scope and Purpose ........................................................................................................................................... 11 Health Questions Addressed by the Guideline .............................................................................................. 12 Target Audience ................................................................................................................................................ 12 Methods.............................................................................................................................................................. 12 Guideline Development Panel ......................................................................................................................... 12 Identification and Appraisal of Existing Guidelines ......................................................................................... 13 • Guideline Search Strategy ................................................................................................................. 13 • Guideline Selection Criteria and Appraisal ........................................................................................ 13 Primary Literature Search for Pediatric Studies .............................................................................................. 14 • Search Strategy ................................................................................................................................. 14 • Selection Criteria and Appraisal ......................................................................................................... 14 • Meta-analysis ..................................................................................................................................... 14 Decision-making Process for Formulation of the Recommendations ............................................................. 14 Evidence Synthesis and Recommendations.................................................................................................. 16 Identification and Appraisal of Existing Guidelines ......................................................................................... 16 Primary Literature Review of Pediatric Oncology Studies .............................................................................. 16 Health Question #1: How is optimal control of acute AINV defined? .............................................................. 17 • Recommendation • Evidence Summary and Discussion Health Question #2a: What pharmacological interventions provide optimal control of acute AINV in children receiving antineoplastic agents of high emetic risk? ...................................................................................... 18 • Recommendation • Evidence Summary and Discussion Health Question #2b: What pharmacological interventions provide optimal control of acute AINV in children receiving antineoplastic agents of moderate emetic risk? ............................................................................. 22 • Recommendation • Evidence Summary and Discussion Health Question #2c: What pharmacological interventions provide optimal control of acute AINV in children receiving antineoplastic agents of low emetic risk? ....................................................................................... 24 • Recommendation • Evidence Summary and Discussion Health Question #2d: What pharmacological interventions provide optimal control of acute AINV in children receiving antineoplastic agents of minimal emetic risk? ................................................................................ 27 • Recommendation • Evidence Summary and Discussion Health Question #3: What adjunctive non-pharmacological interventions provide control of acute AINV in children receiving antineoplastic agents of any emetic risk? ......................................................................... 28 • Recommendation • Evidence Summary and Discussion 3 Version date: February 28, 2013 Health Question #4: What is the role of aprepitant in children receiving antineoplastic therapy? ................ 29 • Recommendation • Evidence Summary and Discussion Health Question #5: What pharmacological interventions provide optimal control of acute AINV in children receiving highly or moderately emetogenic antineoplastic agents in whom corticosteroids are contra- indicated? ...................................................................................................................................................... 32 • Recommendation • Evidence Summary and Discussion Health Question #6: What doses of antiemetic agents are known to be effective in children receiving antineoplastic agents? ................................................................................................................................. 36 • Aprepitant Dose Recommendation • Chlorpromazine Dose Recommendation • Dexamethasone Dose Recommendation • Granisetron Dose Recommendation • Metoclopramide Dose Recommendation • Nabilone Dose Recommendation • Ondansetron Dose Recommendation External Review and Consultation Process ................................................................................................... 52 • Content expert reviewer feedback • Changes to draft recommendations • Stakeholder survey results Plan for Scheduled Review and Update ......................................................................................................... 58 Implementation Considerations ...................................................................................................................... 59 Tools for Application ........................................................................................................................................ 59 Organizational Barriers and Cost Implications .............................................................................................. 59 Key Review Criteria for Monitoring and/or Audit Purposes ......................................................................... 60 Acknowledgements .......................................................................................................................................... 60 Panel Members .................................................................................................................................................
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