{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T11:18:30Z","timestamp":1769599110975,"version":"3.49.0"},"reference-count":22,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncology Practice"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>PURPOSE:<\/jats:title><jats:p> Chemotherapy-induced nausea and vomiting (CINV) is a very common side effect of pediatric cancer therapy. High-quality, evidence-based, pediatric-specific guidelines for prophylaxis and treatment of CINV are available. At many centers, guideline-concordant care is uncommon. We formed a multidisciplinary quality improvement team to implement guideline-concordant care for CINV prophylaxis at our center. We present the results following the first year of our interventions. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p> We planned and implemented a multipronged approach in three key phases: (1) developing and publishing an acute CINV prophylaxis pathway, (2) education of providers, and (3) updating the computerized provider order entry system. We used iterative, sequential Plan-Do-Study-Act cycles and behavioral economic strategies to improve adherence to guideline-concordant CINV prophylaxis. We focused on aprepitant usage as a key area for improvement. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p> At the beginning of the study period, &lt; 50% of patients were receiving guideline-concordant CINV prophylaxis and &lt; 15% of eligible patients were receiving aprepitant. After 1 year, more than 60% of patients were receiving guideline-concordant care and 50% of eligible patients were receiving aprepitant. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION:<\/jats:title><jats:p> We describe the development and implementation of a standardized pathway for prevention of acute CINV in pediatric oncology patients. With a multidisciplinary, multifaceted approach, we demonstrate significant improvements to guideline-congruent CINV prophylaxis. <\/jats:p><\/jats:sec>","DOI":"10.1200\/op.21.00476","type":"journal-article","created":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T19:59:39Z","timestamp":1635364779000},"page":"e412-e419","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":5,"title":["Improving Guideline-Congruent Care for Chemotherapy-Induced Nausea and Vomiting Prophylaxis in Pediatric Oncology Patients"],"prefix":"10.1200","volume":"18","author":[{"given":"Caroline","family":"Diorio","sequence":"first","affiliation":[{"name":"Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Vardaro","sequence":"additional","affiliation":[{"name":"Division of Quality and Safety Services, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yahui","family":"Wei","sequence":"additional","affiliation":[{"name":"Division of Quality and Safety Services, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Mauro","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, Children's Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colleen","family":"Croy","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, Children's Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katelyn E.","family":"Oranges","sequence":"additional","affiliation":[{"name":"Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay","family":"Flanagan","sequence":"additional","affiliation":[{"name":"Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne F.","family":"Reilly","sequence":"additional","affiliation":[{"name":"Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. 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