caa a22 4500 475748816 CHVBK 20180406123521.0 cr unu---uuuuu 170329e20000801xx s 000 0 eng 10.1023/A:1005501914725 doi (NATIONALLICENCE)springer-10.1023/A:1005501914725 Using a Multihospital Systems Framework to Evaluate and Establish Drug Use Policy [Elektronische Daten] [Lee Vermeulen, Paul Windisch, Robert Rydman, Ruth Bruskiewitz, Diana Brixner, Peter Vlasses] Purpose. In order to develop rational drug purchasing and use policy for a class of pharmaceuticals used in a consortium system of 14 university based hospitals, the antiemetic use patterns of inpatients receiving cancer chemotherapy were evaluated to assess the comparative effectiveness of granisetron, ondansetron, and conventional antiemetics. Patients and Methods. A prospective, observational study was conducted in 14 academic health centers linked under research and purchasing consortium arrangements from October to December 1994. The use of antiemetics was evaluated in hospitalized patients receiving cancer chemotherapy agents with a known propensity for causing, alone or in combination, varying degrees of nausea or vomiting. Clinical outcomes measured were the impact of chemotherapy administration on the functional status of patients, and the occurrence of post-treatment vomiting. Results. The most often prescribed cancer chemotherapy regimens consisted of cisplatin, paclitaxel, etoposide and cyclophosphamide, and the most often prescribed antiemetics were the 5-hydroxytryptamine subtype-3 antagonists (5-HT3 antagonists, granisetron and ondansetron), dexamethasone and lorazepam. Of the 439 patients studied, 329 (75%) reported no episodes of emesis. Of the patients receiving highly emetogenic chemotherapy, those receiving 5-HT3 antagonists experienced better overall outcomes (as measured by functional health status and the absence of vomiting) than patients receiving conventional (non-5-HT3 antagonist) antiemetics. In contrast, patients receiving chemotherapy associated with moderate or low emetogenicity experienced similar outcomes, regardless of the antiemetic regimen selected. No statistical difference was seen between granisetron and ondansetron in achieving positive patient outcomes. Conclusion. The study results suggest that 5-HT3 antagonists are associated with better clinical outcomes than other antiemetics in patients receiving highly emetogenic chemotherapy. Less costly conventional antiemetic therapy (or, in some cases, no antiemetic therapy) provide comparable outcomes in patients receiving chemotherapy associated with moderate or low emetogenic potential. Granisetron and ondansetron were found to be clinically comparable. Plenum Publishing Corporation, 2000 multihospital systems nationallicence consortium research nationallicence drug policy nationallicence drug use nationallicence Vermeulen Lee Center for Drug Policy and Clinical Economics, University of Wisconsin Hospital and Clinics. University of Wisconsin-Madison, School of Pharmacy, USA aut Windisch Paul Department of Pharmacy, Baptist Memorial Hospital, Memphis, Tennessee aut Rydman Robert School of Public Health, University of Illinois at Chicago, USA aut Bruskiewitz Ruth University of Wisconsin-Madison, School of Pharmacy, USA aut Brixner Diana Novartis Pharmaceuticals, USA aut Vlasses Peter American Council on Pharmaceutical Education, Chicago, Illinois aut Journal of Medical Systems Kluwer Academic Publishers-Plenum Publishers 24/4(2000-08-01), 235-246 0148-5598 24:4<235 2000 24 10916 https://doi.org/10.1023/A:1005501914725 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1005501914725 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Vermeulen Lee Center for Drug Policy and Clinical Economics, University of Wisconsin Hospital and Clinics. University of Wisconsin-Madison, School of Pharmacy, USA aut NATIONALLICENCE 700 1- Windisch Paul Department of Pharmacy, Baptist Memorial Hospital, Memphis, Tennessee aut NATIONALLICENCE 700 1- Rydman Robert School of Public Health, University of Illinois at Chicago, USA aut NATIONALLICENCE 700 1- Bruskiewitz Ruth University of Wisconsin-Madison, School of Pharmacy, USA aut NATIONALLICENCE 700 1- Brixner Diana Novartis Pharmaceuticals, USA aut NATIONALLICENCE 700 1- Vlasses Peter American Council on Pharmaceutical Education, Chicago, Illinois aut NATIONALLICENCE 773 0- Journal of Medical Systems Kluwer Academic Publishers-Plenum Publishers 24/4(2000-08-01), 235-246 0148-5598 24:4<235 2000 24 10916 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer