Impact of Guideline Adherence on the Prevention of Chemotherapy-Induced Nausea and Vomiting: A Narrative Review

Abstract

Chemotherapy-Induced Nausea and Vomiting (CINV) is among the most distressing adverse effects experienced by patients receiving cancer chemotherapy. Inadequate control of CINV is still a serious clinical concern despite significant improvements in antiemetic medicine and the creation of thorough worldwide management guidelines. Organizations like the National Comprehensive Cancer Network (NCCN), American Society of Clinical Oncology (ASCO) and Multinational Association of Supportive Care in Cancer (MASCC) have developed evidence-based recommendations that offer guidance for choosing suitable antiemetic regimens. To review current evidence on adherence to international antiemetic guidelines and evaluate the impact of guideline-concordant therapy on the prevention and management of CINV. A narrative review of published literature was conducted focusing on international antiemetic guidelines, including recommendation from NCCN, ASCO and MASCC. Studies assessing adherence, practice gaps, contributing factors and strategies to improve implementation were analysed. Evidence indicates that adherence to antiemetic protocols varies significantly between therapeutic settings. Inappropriate regimen selection, inconsistent prescribing methods, and underuse of prophylaxis for delayed CINV are common deviations. Medication accessibility, institutional challenges, patient-related variables, and a lack of knowledge about revised guidelines are all factors that affect adherence. Electronic decision-support systems, institutional protocols, and clinical pharmacist involvement were found to be successful methods for increasing adherence. Enhancing patient comfort, maintaining chemotherapy adherence, and optimizing clinical results all depend on better adherence to antiemetic medication as advised by guidelines. To bridge the gap between evidence and real-world application, multidisciplinary interventions and implementation methods are required.

Keywords: Adherence; Antiemetics; Chemotherapy-induced nausea and vomiting; Emetogenic; drugs; Guidelines