{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:09:58Z","timestamp":1789034998273,"version":"build-2803163510"},"reference-count":29,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UM1TR004406"],"award-info":[{"award-number":["UM1TR004406"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hosp Pharm"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Since 2017, guidelines recommend a four-drug prophylactic antiemetic regimen\u20145HT3 receptor antagonist (5HT3RA), NK1 receptor antagonist (NK1RA), dexamethasone, and olanzapine\u2014for patients receiving highly emetogenic chemotherapy (HEC). This study examines prophylactic olanzapine prescribing in patients initiating HEC and associated sociodemographic, clinical, and contextual factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using electronic health record data from an academic cancer center and affiliated community practices across the state of North Carolina, joined with geocoded community factors. Adults \u226521\u2009years initiating cisplatin, carmustine, dacarbazine, mechlorethamine, streptozocin, or cyclophosphamide plus anthracycline (AC) in 2022 were included. Antiemetic orders placed before HEC administration were classified as three-drug (5HT3RA, NK1RA, dexamethasone) or four-drug (plus olanzapine). Late olanzapine use (within 30\u2009days post-HEC) was also assessed. Multivariable logistic regression evaluated factors associated with regimen type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 878 patients, all received orders for the three-drug regimen, but only 300 (34.2%) had olanzapine ordered within 30\u2009days before first HEC. After adjusting for covariates, olanzapine prescribing was less likely in patients with breast (OR\u2009=\u20090.13, 95%CI\u2009=\u20090.07-0.23), gastrointestinal (OR\u2009=\u20090.20, 95%CI\u2009=\u20090.04-0.94), gynecological (OR\u2009=\u20090.14, 95%CI\u2009=\u20090.03-0.69), and head and neck (OR\u2009=\u20090.17, 95%CI\u2009=\u20090.05-0.66) compared to hematological cancers, in those receiving cisplatin (OR\u2009=\u20090.20, 95%CI\u2009=\u20090.06-0.70) and carmustine (OR\u2009=\u20090.02, 95%CI\u2009=\u20090.00-0.48) compared to AC, and in community (OR\u2009=\u20090.40, 95%CI\u2009=\u20090.27-0.61) versus academic settings. Prescribing was also lower among patients residing in low- (OR\u2009=\u20090.49, 95%CI\u2009=\u20090.25-0.93) or lower-middle income (OR\u2009=\u20090.50, 95%CI\u2009=\u20090.32-0.78) areas, but higher among those living &gt;6\u2009miles from treatment facilities (OR\u2009=\u20091.95, 95%CI\u2009=\u20091.08-3.58). Among patients without prophylactic olanzapine, 12.5% were prescribed it within 1 to 30\u2009days post-HEC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Despite guideline recommendations, prophylactic olanzapine use in HEC remains suboptimal, influenced by clinical and non-clinical contextual factors. Targeted efforts at information dissemination and updated prescribing systems are needed to promote equitable, evidence-based supportive care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00185787251396790","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T07:14:49Z","timestamp":1765869289000},"page":"279-289","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Real-World Determinants of Olanzapine Prescribing for Antiemetic Prophylaxis in Adults Receiving Highly-Emetogenic Chemotherapy"],"prefix":"10.1177","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6193-9578","authenticated-orcid":false,"given":"Soroush","family":"Fariman","sequence":"first","affiliation":[{"name":"University of North Carolina at Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haneul","family":"Gil","sequence":"additional","affiliation":[{"name":"University College London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Chen","sequence":"additional","affiliation":[{"name":"University of North Carolina Medical Center, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob N.","family":"Stein","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill, NC, USA"},{"name":"UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Elston Lafata","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill, NC, USA"},{"name":"UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0277-5379(83)90418-2"},{"issue":"4","key":"e_1_3_3_3_2","first-page":"3503","article-title":"On the receiving end: have patient perceptions of the side-effects of cancer chemotherapy changed since the twentieth century?","volume":"30","author":"Vardy JL","year":"2022","unstructured":"Vardy JL, Liew A, Warby A, et al On the receiving end: have patient perceptions of the side-effects of cancer chemotherapy changed since the twentieth century? Support Care Cancer. 2022;30(4):3503-3512.","journal-title":"Support Care Cancer"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-009-0797-x"},{"key":"e_1_3_3_5_2","first-page":"173","article-title":"Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system","volume":"2016","author":"Rashid N","unstructured":"Rashid N, Koh HA, Baca HC, Lin KJ, Malecha SE, Masaquel A. Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system. 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