Evolving roles of oncology pharmacists in Singapore: A survey on prescribing patterns of antiemetics for chemotherapy induced nausea and vomiting (CINV) at a cancer centre†

Abstract

Background. National Cancer Centre (NCC) is currently the largest ambulatory oncology treatment centre in Singapore that treats mainly solid tumors and lymphomas. Oncology pharmacists at NCC play an active role in the management of CINV. In order to improve the clinical services delivered by pharmacy, particularly in the utilization of antiemetics, pharmacy department conducted a survey that aimed to understand the prescribing patterns of antiemetics for CINV. Objectives. ves. The primary aim of this study was to describe medical oncologists' perceptions of factors that can influence prescribing of antiemetics for acute and delayed nausea and vomiting associated with chemotherapy. A secondary aim was to assess medical oncologists' perception of antiemetic counseling by oncology pharmacists. Methods. This was a single-centered, non-randomized survey conducted at NCC in Singapore. Twenty-seven oncologists in the Department of Medical Oncology (DMO) were invited to participate in this survey. Survey forms were distributed to the medical oncologists at weekly DMO and tumor board meetings in November 2006. Results. Twenty oncologists returned surveys during the study period. Most oncologists closely adhered to the institution guideline on antiemetics utilization; however, results showed a trend of overprescribing acute antiemetics for low emetogenic chemotherapy regimens. Oncologists have identified anxiety, age and gender as the top three patient risk factors taken into consideration when they prescribe antiemetics. Majority of oncologists found pharmacists' counseling on antiemetics to be effective. Conclusions. Through this survey, oncology pharmacists at NCC were able to identify areas of antiemetics utilization that needed refinement. Results from this survey provide opportunities for oncology pharmacists to collaborate with medical oncologists to further improve the management of chemotherapy induced nausea and vomiting. J Oncol Pharm Practice (2008) 14: 23—29.