Phân tích thực trạng kê đơn thuốc dự phòng biến cố nôn và buồn nôn do hoá trị liệu trên bệnh nhân ung thư tại bệnh viện Phụ sản Trung ương=Prescribing chemotherapy-induced nausea and vomiting prophylaxis for cancer patients at the National hospital of Obstetrics and Gynecology: a situation analysis

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Tác giả: Thị Phương Hoàng, Thành Hải Nguyễn, Thị Hồng Hạnh Nguyễn, Thị Liên Hương Nguyễn, Thị Thảo Nguyễn, Văn Thắng Nguyễn, Thị Hải Hà Thân, Thị Thu Trang Trần, Thị Mai Quỳnh Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.260-269

Bộ sưu tập: Metadata

ID: 478156

Thêm vào giỏ

Phân tích tính phù hợp theo hướng dẫn điều trị trong kê đơn thuốc dự phòng biến cố nôn và buồn nôn (CINV) do hóa trị liệu trên bệnh nhân ung thư. Đối tượng phương pháp: Nghiên cứu mô tả cắt ngang trên các bệnh nhân được chẩn đoán ung thư và có chỉ định điều trị hoá chất tại khoa Phụ ung thư, bệnh viện Phụ sản Trung ương từ 05/12/2023 đến 29/02/2024. Kết quả: Tổng cộng 127 bệnh nhân được đưa vào nghiên cứu, tương ứng với 286 chu kỳ hoá chất. Trong đó có 73 bệnh nhân mắc ung thư buồng trứng, chiếm 57,5% và 46 bệnh nhân u nguyên bào nuôi, chiếm 36,2%. Ở giai đoạn cấp và muộn, phác đồ hóa trị có nguy cơ CINV cao và trung bình có tỷ lệ tương ứng là 50,7% và 14,7%
và 38,8% và 14,7%. Trong số 286 chu kỳ, tỷ lệ số chu kỳ được kê đơn dự phòng nôn và buồn nôn ở giai đoạn cấp và muộn lần lượt là 72,0% và 56,5%. Phác đồ dự phòng CINV không được cá thể theo nguy cơ CINV của phác đồ hóa trị, chủ yếu là phối hợp hai thuốc gồm 1 thuốc kháng thụ thể 5-HT3 và corticosteroids, tỷ lệ phù hợp về phác đồ lần lượt là 28,3% và 38,1% ở giai đoạn dự phòng cấp và muộn. Các vấn đề kê đơn thuốc dự phòng CINV chưa phù hợp với khuyến cáo của Bộ Y tế chủ yếu là: thiếu thuốc và thiếu liều dùng với phác đồ nguy cơ cao, thừa thuốc với phác đồ nguy cơ thấp. Kết luận: Thực trạng kê đơn dự phòng biến cố CINV trong thực hành lâm sàng còn chưa được cá thể hoá theo nguy cơ của phác đồ hoá trị liệu. Tiếp tục thực hiện các đánh giá mối liên quan của việc dự phòng với biến cố CINV để có căn cứ xây dựng các can thiệp phù hợp nhằm quản lý biến cố CINV.To analyze the appropriateness based on treatment guidelines, of prescribing patterns of prophylactic medication for chemotherapy-induced nausea and vomiting (CINV) in cancer patients Methods: A cross-sectional descriptive study was conducted on cancer patients diagnosed and undergoing chemotherapy at the Oncology Gynecology Department, National Hospital of Obstetrics and Gynecology, from December 5, 2023, to February 29, 2024. Results: A total of 127 patients, corresponding to 286 chemotherapy cycles, were analyzed. Among them, 73 patients (57.5%) were diagnosed with ovarian cancer, and 46 patients (36.2%) were diagnosed with gestational trophoblastic neoplasia. The proportions of chemotherapy regimens with high and moderate risk for CINV in the acute and delayed phases were 50.7% and 14.7%
38.8% and 14.7%, respectively. Of the 286 cycles, the proportion of patients prescribed prophylaxis for CINV in the acute and delayed phases was 72.0% and 56.5%, respectively. The CINV prophylactic regimens were not individualized according to the CINV risk, with most regimens combining a 5-HT3 receptor antagonist and corticosteroids. The rate of appropriate prophylactic regimens was 28.3% in the acute phase and 38.1% in the delayed phase. Regarding the compliance with the Ministry of Health guidelines, the main issues in prescribing CINV prophylaxis were under-dosing in high-risk regimens and over-prescribing in low-risk regimens. Conclusion: Currently, prescribing CINV prophylaxis in clinical practice has not yet been individualized according to the emetogenic risk of the chemotherapy regimen. It is essential to further identify factors related to CINV prophylaxis to develop appropriate interventions for CINV management.

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