Evaluation of Antiemetic Consistency in Chemotherapy-Induced Nausea and Vomiting Among NHL Patients in Sana’a, Yemen

Mohammed Mohammed Battah,1,2 Hadzliana Zainal,1 Doa’a Anwar Ibrahim,2 Nur Hafzan Binti Md Hanafiah,1 Syed Azhar Syed Sulaiman,1 Abdulsalam Halboup1,2 1Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; 2Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana’a, YemenCorrespondence: Mohammed Mohammed Battah, Departments of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana’a, Yemen, Tel +‏ 967777404880, Email mmalbattah@gmail.com Hadzliana Zainal, Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, 11800, Malaysia, Email hadz@usm.myBackground: Chemotherapy-induced nausea and vomiting (CINV) is a prevalent and distressing adverse effect that can negatively affect a patient’s quality of life and treatment adherence.Purpose: This study aimed to evaluate the consistency of antiemetic use with standard guidelines and to examine the factors influencing it.Methods: This cross-sectional study was conducted at the National Oncology Center (NOC) of Al-Jomhouri Teaching Hospital, Sana’a, Yemen, from November 2022 to September 2023. Demographic data, chemotherapy and antiemetic regimens, dosages, and patient-related risk factors were collected via direct interviews, medical records, and treatment charts. This study evaluated the consistency of antiemetic practices among non-Hodgkin’s Lymphoma (NHL) patients using the National Comprehensive Cancer Network (NCCN) guidelines. The chi-squared test and regression were used to determine the factors associated with guideline consistency.Results: A total of 251 patients with NHL were recruited for the study; 57.4% were male and 60.6% were aged between 18– 49. Most of the patients received moderately emetogenic chemotherapy (81.3%). The overall consistency with the NCCN guidelines was only 23.9%, with antiemetic drug selection and dosage reported inconsistently in 62.9% and 16.7% of patients, respectively. Furthermore, 62.5% of the patients received an under-prescribed antiemetic prophylactic regimen. Treatment duration, number of chemotherapy cycles, emetogenic risk potential, and overall patient risk, as well as age, sex, and marital status, were significantly associated with guideline inconsistency (p < 0.05).Conclusion: This study revealed a notable gap in the consistency of antiemetic prescriptions among patients with NHL. Inappropriate drug selection, dosing, and under-prescription are common problems. Patient regimen risk factors significantly influenced the consistency of the National Comprehensive Cancer Network guidelines. Personalized approaches are essential to enhance adherence to guidelines and improve antiemetic strategies.Keywords: non-Hodgkin’s Lymphoma, chemotherapy, nausea, vomiting, antiemetics, Yemen