Pharmacy Care Model For Chemotherapy-Induced Nausea And Vomiting To Achieve Improved Outcome Of Antiemetic Therapy In Cancer Patients (Study on Patients Outpatient Cancer in Rumah Sakit Umum Daerah Ulin Banjarmasin)
Knowledge of the pathophysiology of chemotherapy-induced nausea and vomiting (CINV) and the discovery of new antiemetic agents continues to evolve, but CINV remains a problem experienced by approximately 40–80% of patients. This study was divided into three stages. The first stage was a cross-sectional study to identify factors that decrease the outcome of antiemetic therapy in chemotherapy patients at Ulin Regional General Hospital (RSUD) Banjarmasin. The second stage was a qualitative study to develop a pharmaceutical care model in collaborative practice. The third stage was a quasi-experimental one-group pre-post study aimed to analyze the effect of implementing a pharmaceutical care model for chemotherapy-induced nausea and vomiting in collaborative practice on antiemetic outcomes. The following factors have been identified as contributing to a suboptimal outcome in patients receiving antiemetic therapy at Ulin Banjarmasin Regional General Hospital: The administration of antiemetic therapy for chemotherapy with high emetogenic potential, which is not in accordance with the evidence-based algorithm; The inconsistent timing of premedication antiemetic administration; Additionally, CINV monitoring was not carried out, and the level of knowledge, attitudes, and behaviors related to CINV and the use of antiemetics after chemotherapy was low. Furthermore, patient compliance with antiemetic use after chemotherapy was low, and the existing chemotherapy service flow did not accommodate the implementation of pharmaceutical care. Therefore, the following four instruments were agreed upon to support the implementation of the pharmaceutical care model for chemotherapy-induced nausea and vomiting (CINV) in cancer patients: 1) The CINV pharmaceutical care module for cancer patients; 2) The integrated CINV monitoring sheet; 3) The CINV education and monitoring book; and 4) The proposed special services for patients receiving chemotherapy regimens with moderate-to-high emetogenic potential The pharmaceutical care model was then implemented in 105 patients undergoing three cycles of chemotherapy. The research results indicate that the pharmaceutical care model in collaborative practice for nausea and vomiting due to chemotherapy can improve the outcome of antiemetic therapy in cancer patients.
Keywords: CINV, pharmaceutical care model, antiemetics, compliance
