Efficacy of an antiemetic therapeutic interchange protocol driven by a medically integrated pharmacy.

133Background: Control of chemotherapy induced nausea and vomiting (CINV) remains an unmet need. An antiemetic therapeutic interchange protocol was developed to enhance control of CINV. This abstract reports the efficacy results of patients treated with highly emetogenic regimens as defined by NCCN guidelines. Methods: Medically integrated pharmacists imbedded within 2 centers of a community oncology practice evaluated each new chemotherapy order and adjusted antiemetics including a 5HT3 antagonist, steroids, olanzapine and an NK1 inhibitor using an NCCN based protocol. Exact medications depended on insurance coverage and copays. Medications were adjusted for patient comorbidities, drug interactions and patient refusal. All patients were given prochlorperazine and ondansetron for breakthrough nausea and vomiting. Medication education to increase adherence was provided by the pharmacist, nurse and advance practice provider. Patients were evaluated by nursing or pharmacist calls on day 2 and 3 and as needed...