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through force of habit and some do not participate actively in upgrading their practices. Hence, the development of antiemetic guidelines can overcome all the above informational and practice delivery issues by providing readily available evidence-based statements of antiemetic treatment options. Conclusions Generally speaking, 20–30% of patients receiving chemotherapy and receiving standard antiemetics will experience vomiting and about half will experience nausea, with vomiting being better controlled than nausea and acute nausea and vomiting being better controlled than delayed symptoms. Hence, this area of supportive care is still not optimal, despite the significant investment in antiemetic drug research and development and the introduction of newer and more potent antiemetics. The use of antiemetic guidelines will ensure that the care provided to cancer patients is based on evidence, improves health outcomes and potentially decreases costs. References 1 Institute of Medicine Committee on Standards for Developing Trustworthy Clinical Practice Guidelines. Graham R et al (eds). Clinical Practice Guidelines we can Trust. Washington (DC): National Academies Press; 2011. www.ncbi.nlm.nih.gov/books/NBK209539/ (accessed June 2019). 2 Atkins D et al. Grading quality of evidence and strength of recommendations. BMJ 2004;328:1490. 24 | 2019 | hospitalpharmacyeurope.com 3 Schunemann HJ, Fretheim A, Oxman AD. Improving the use of research evidence in guideline development: 10. Integrating values and consumer involvement. Health Res Policy Syst 2006;4. 4 Molassiotis A et al. A prospective observational study of chemotherapy-related nausea and vomiting in routine practice in a UK cancer centre. Support Care Cancer 2008;16(2):201–8. 5 Hayashi T et al. Implementation of institutional antiemetic guidelines for low emetic risk chemotherapy with docetaxel: a clinical and cost evaluation. Support Care Cancer 2012;20(8):1805–10. 6 Aapro M et al. The effect of guideline- consistent antiemetic therapy on chemotherapy- induced nausea and vomiting (CINV): the Pan European Emesis Registry (PEER). Ann Oncol 2012;23(8):1986–92. 7 Jordan K et al. International antiemetic guidelines on chemotherapy induced nausea and vomiting (CINV): content and implementation in daily routine practice. Eur J Pharmacol 2014;722:197–202. 8 Roila F. Transferring scientific evidence to oncological practice: a trial on the impact of three different implementation strategies on antiemetic prescriptions. Support Care Cancer 2004;12:446–53. 9 Molassiotis A et al. Evaluation of risk factors predicting chemotherapy-related nausea and vomiting: results from a European prospective observational study. J Pain Symptom Manage 2014;47(5):839–48. 10 Dranitsaris G et al. The development of a prediction tool to identify cancer patients at high risk for chemotherapy-induced nausea and vomiting. Ann Oncol 2017;28(6):1260–7. 11 Roila F et al. 2016 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting and of nausea and vomiting in advanced cancer patients. Ann Oncol 2016;27(suppl 5):v119–v133. 12 Hesketh PJ et al. Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2017;35:3240–62. 13 NCCN Clinical Practice Guidelines in Oncology. Antiemesis. V1.2019. www.nccn.org/ patients (accessed July 2019). 14 Jordan K, Jahn F, Aapro M. Recent developments in the prevention of chemotherapy-induced nausea and vomiting (CINV): A comprehensive review. Ann Oncol 2015;26:1081–90.