Prophylaxis Improves Postchemotherapy Nausea/Vomiting Frequency, Hospitalizations

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Postchemotherapy hospitalizations and costs are higher for patients receiving highly emetogenic chemotherapy with no prophylaxis treatment.
Postchemotherapy hospitalizations and costs are higher for patients receiving highly emetogenic chemotherapy with no prophylaxis treatment.
The following article features coverage from the 2018 Palliative Care in Oncology Symposium meeting. Click here to read more of Oncology Nurse Advisor's conference coverage.

Nausea and vomiting can lead to expensive hospitalizations for patients receiving highly emetogenic chemotherapy, according to study results presented at the 2018 Palliative and Supportive Care in Oncology Symposium.

Based on a 2016 Medicare estimate, nearly 10% of preventable toxicity-associated hospitalizations postchemotherapy are due to nausea and vomiting. The researchers quantified the costs associated with this by querying the Truven MarketScan database of US claims for hospitalizations with a primary diagnosis of nausea or vomiting along with a secondary diagnosis of cancer from January 2011 to June 2017. The researchers identified 5293 cases, and all but 62 showed cost data.

Four days was the mean length of hospitalization with a mean cost per hospitalization of $15,085 (2017 USD). Mean costs were lower for Medicare than for non-Medicare admissions (P <.01), but costs were similar by tumor type.

Cost was $13,882 per hospitalization among the 65% of patients with a chemotherapy claim within 30 days before admission. Furthermore, 45% of the chemotherapies were highly emetogenic, yet prophylaxis with an NK1 receptor antagonist was not included with more than half of those chemotherapies.

The authors concluded that the average cost of more than $15,000 per hospitalization for nausea/vomiting suggests that this symptom is insufficiently managed. They noted also that a high proportion of patients are not getting antiemetic prophylaxis for highly emetogenic chemotherapy.

The authors concluded that the parenteral opioid shortage had a significant effect on administration of opioids to patients for treatment of cancer-related pain and that this is linked with overall poorer analgesia.

The authors concluded that the parenteral opioid shortage had a significant effect on administration of opioids to patients for treatment of cancer-related pain and that this is linked with overall poorer analgesia.

Reference

Roeland E, Nipp RD, Ruddy KJ, et al. Inpatient hospitalization costs associated with nausea and vomiting among patients with cancer. J Clin Oncol. 2018;36(suppl 34). Abstract 112.

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