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Professor of Nursing, Warwick Medical School, University of Warwick, Coventry, UK
Can you briefly explain what the patient’s charter for Chemotherapy-induced nausea and vomiting (CINV) management is and why it is important? The CINV patient charter provides information and guidance for patients and their carers on CINV. More importantly, it sets out key questions for patients, with their carers, to ask their healthcare professionals about how their own risk of CINV will be managed and how they can participate in this management. The European-wide CINV charter is important as patients tell us that CINV is one of the most feared and expected side effects of cancer treatment. Patients and their carers are the main participants in effective management. CINV not only impairs health and quality of life, it can also lead to a decision to delay or reduce the next dose of chemotherapy, or even to stop treatment altogether. Yet physicians frequently underestimate rates of nausea and vomiting secondary to chemotherapy, particularly if the symptoms occur once a patient has left hospital.
Are there not already sufficient guidelines/advice in place for patients? There are far too many guidelines aimed at healthcare professionals which are not always followed in different European countries for various reasons. However, there are few specific guidelines for patients and their carers. We are not aware of any list of evidence-based questions about CINV; these encourage patients and their carers to be active participants in their care and also encourage self-management where possible.
How has the charter been adopted and are patients being made aware of these guidelines? The charter has been adopted by the organisations of the healthcare professionals (some of whom were patient liaison personnel from cancer charities) and we have striven to more widely disseminate through ecancermedicalscience as well as oncology nursing organisations throughout Europe and many cancer centres.
How would adopting these guidelines impact on a patient’s quality of life? The patient charter provides patients and their carers with the information needed to take control of the prevention and treatment of CINV in partnership with their healthcare professionals. This has the potential of encouraging best practice, in particular in the prevention and management of nausea, thereby improving quality of life. The impact remains to be formally measured.
How is CINV management affected from a clinician’s point of view? This encourages the clinicians to firstly discuss CINV prevention and treatment and focus on the individual patient’s symptoms (in the short time they have available to see the patient). The use of international guidelines is recommended in the patient charter. This certainly raises clinicians’ awareness of the latest guidelines and may support them in lobbying policymakers in their health sector to implement best practice.