Factors affecting the implementation of guideline-based prophylactic antiemetic therapy for chemotherapy-induced nausea and vomiting in Japan: a protocol for a hospital-based qualitative study

Introduction Chemotherapy-induced nausea and vomiting (CINV) decrease patients’ quality of life and negatively impact treatment outcomes. Although standard prophylactic antiemetic therapy for acute CINV recommended by guidelines is effective, poor guideline implementation is a worldwide problem. In...

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Main Authors: Yosuke Uchitomi, Junko Saito, Maiko Fujimori, Taichi Shimazu, Ayako Okuyama, Sadamoto Zenda, Ayumu Matsuoka, Akiko Yaguchi-Saito, Yuki Kaji, Miyuki Odawara, Aki Otsuki
Format: Article
Language:English
Published: BMJ Publishing Group 2022-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/6/e055473.full
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author Yosuke Uchitomi
Junko Saito
Maiko Fujimori
Taichi Shimazu
Ayako Okuyama
Sadamoto Zenda
Ayumu Matsuoka
Akiko Yaguchi-Saito
Yuki Kaji
Miyuki Odawara
Aki Otsuki
author_facet Yosuke Uchitomi
Junko Saito
Maiko Fujimori
Taichi Shimazu
Ayako Okuyama
Sadamoto Zenda
Ayumu Matsuoka
Akiko Yaguchi-Saito
Yuki Kaji
Miyuki Odawara
Aki Otsuki
author_sort Yosuke Uchitomi
collection DOAJ
description Introduction Chemotherapy-induced nausea and vomiting (CINV) decrease patients’ quality of life and negatively impact treatment outcomes. Although standard prophylactic antiemetic therapy for acute CINV recommended by guidelines is effective, poor guideline implementation is a worldwide problem. In Japan, prophylactic antiemetic therapy is relatively well implemented for chemotherapy associated with high emetogenic risk, while implementation gaps are observed for that with low emetogenic risk.Although most reports on factors influencing appropriate antiemetic prescription focus on physicians’ attitudes and behaviours, a more comprehensive exploration is needed since chemotherapy is expected to involve pharmacists, nurses and eventually hospital directors. The purpose of this qualitative study is to comprehensively explore the factors that influence the implementation of appropriate prophylactic antiemetic procedures at cancer care hospitals in Japan.Methods and analysis This study is a hospital-based qualitative study using semistructured individual interviews. The target population will be hospital directors, and chiefs (including proxies) of departments of oncology and/or chemotherapy, pharmacy and nursing, working in the hospitals, selected by purposive sampling. We will obtain information on antiemetics in chemotherapy regimens, antiemetic routine use and awareness of guidelines using prequestionnaires. Interviews will then be conducted online using an interview guide. The Consolidated Framework for Implementation Research will be used to collect and analyse the interview data. We will also create new codes inductively, as required. In addition, we will refer to the aggregate results of the Quality Indicator survey to determine the implementation of recommended antiemetic prescriptions for each hospital and discuss the relationship with influencing factors.Ethics and dissemination This study has been approved by the National Cancer Centre Ethics Approval Committee (approval number: 2020-305). The study findings will be disseminated via peer-reviewed journal publications and presentations to academics, policy-makers, and clinicians at scientific conferences.
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spelling doaj-art-e6b6580b610244748a1e9be6fe26ff1c2025-01-24T16:50:08ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-055473Factors affecting the implementation of guideline-based prophylactic antiemetic therapy for chemotherapy-induced nausea and vomiting in Japan: a protocol for a hospital-based qualitative studyYosuke Uchitomi0Junko Saito1Maiko Fujimori2Taichi Shimazu3Ayako Okuyama4Sadamoto Zenda5Ayumu Matsuoka6Akiko Yaguchi-Saito7Yuki Kaji8Miyuki Odawara9Aki Otsuki10Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, & Behavioral and Survivorship Research Group, Center for Public Health Sciences, Tokyo, JapanBehavioral Science Division, Center for Public Health Sciences, National Cancer Center Japan, Chuo-ku, Tokyo, Japan1 Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, JapanDivision of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji,Chuo-ku, Tokyo, 104-0045, JapanGraduate School of Nursing, St Luke`s International University, Chuo-ku, Tokyo, JapanRadiation Oncology, National Cancer Center Hospital East, Chiba, JapanDivision of Survivorship Research, Institute for Cancer Control, National Cancer Center, Tokyo, JapanDivision of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji,Chuo-ku, Tokyo, 104-0045, JapanDivision of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji,Chuo-ku, Tokyo, 104-0045, JapanDivision of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji,Chuo-ku, Tokyo, 104-0045, JapanDivision of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji,Chuo-ku, Tokyo, 104-0045, JapanIntroduction Chemotherapy-induced nausea and vomiting (CINV) decrease patients’ quality of life and negatively impact treatment outcomes. Although standard prophylactic antiemetic therapy for acute CINV recommended by guidelines is effective, poor guideline implementation is a worldwide problem. In Japan, prophylactic antiemetic therapy is relatively well implemented for chemotherapy associated with high emetogenic risk, while implementation gaps are observed for that with low emetogenic risk.Although most reports on factors influencing appropriate antiemetic prescription focus on physicians’ attitudes and behaviours, a more comprehensive exploration is needed since chemotherapy is expected to involve pharmacists, nurses and eventually hospital directors. The purpose of this qualitative study is to comprehensively explore the factors that influence the implementation of appropriate prophylactic antiemetic procedures at cancer care hospitals in Japan.Methods and analysis This study is a hospital-based qualitative study using semistructured individual interviews. The target population will be hospital directors, and chiefs (including proxies) of departments of oncology and/or chemotherapy, pharmacy and nursing, working in the hospitals, selected by purposive sampling. We will obtain information on antiemetics in chemotherapy regimens, antiemetic routine use and awareness of guidelines using prequestionnaires. Interviews will then be conducted online using an interview guide. The Consolidated Framework for Implementation Research will be used to collect and analyse the interview data. We will also create new codes inductively, as required. In addition, we will refer to the aggregate results of the Quality Indicator survey to determine the implementation of recommended antiemetic prescriptions for each hospital and discuss the relationship with influencing factors.Ethics and dissemination This study has been approved by the National Cancer Centre Ethics Approval Committee (approval number: 2020-305). The study findings will be disseminated via peer-reviewed journal publications and presentations to academics, policy-makers, and clinicians at scientific conferences.https://bmjopen.bmj.com/content/12/6/e055473.full
spellingShingle Yosuke Uchitomi
Junko Saito
Maiko Fujimori
Taichi Shimazu
Ayako Okuyama
Sadamoto Zenda
Ayumu Matsuoka
Akiko Yaguchi-Saito
Yuki Kaji
Miyuki Odawara
Aki Otsuki
Factors affecting the implementation of guideline-based prophylactic antiemetic therapy for chemotherapy-induced nausea and vomiting in Japan: a protocol for a hospital-based qualitative study
BMJ Open
title Factors affecting the implementation of guideline-based prophylactic antiemetic therapy for chemotherapy-induced nausea and vomiting in Japan: a protocol for a hospital-based qualitative study
title_full Factors affecting the implementation of guideline-based prophylactic antiemetic therapy for chemotherapy-induced nausea and vomiting in Japan: a protocol for a hospital-based qualitative study
title_fullStr Factors affecting the implementation of guideline-based prophylactic antiemetic therapy for chemotherapy-induced nausea and vomiting in Japan: a protocol for a hospital-based qualitative study
title_full_unstemmed Factors affecting the implementation of guideline-based prophylactic antiemetic therapy for chemotherapy-induced nausea and vomiting in Japan: a protocol for a hospital-based qualitative study
title_short Factors affecting the implementation of guideline-based prophylactic antiemetic therapy for chemotherapy-induced nausea and vomiting in Japan: a protocol for a hospital-based qualitative study
title_sort factors affecting the implementation of guideline based prophylactic antiemetic therapy for chemotherapy induced nausea and vomiting in japan a protocol for a hospital based qualitative study
url https://bmjopen.bmj.com/content/12/6/e055473.full
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