OBJECTIVES: This study assessed non-adherence rate with the guidelines at a cancer treatment center in Ethiopia and the determine the impact of guideline non adherence on the incidence of CINV and patient quality of life;

METHODS: A prospective observational study was conducted in the cancer treatment center of University of Gondar Teaching and Referral Hospital (UoGTRH), Ethiopia from April -September 2017. Participants were male and female between 18 and 65 years of age with confirmed diagnosis of cancer and had received chemotherapy with minimum emetogenic potential. After enrolment, the consistency of antiemetic drugs was assessed using MASCC guideline. Turkish version of the Functional Living Index-Emesis (FLIE) questionnaire was used to assess the patient’s quality of life in patients on chemotherapy.

RESULTS: From the total 156 patients, 57% were females and the mean age was 46(SD: 14.21). Gastrointestinal cancers was the most common diagnosis (39 %). The prevalence of non- adherent to guideline for CINV prevention in the first cycle was 78%. Under-prescription (34%) and inappropriate prescription (29%) were the identified reason for non-adherent to antiemetic guideline. The median FLIE score for patients adherent to guideline was 118 while there is significant decline was observed among patients non adherent to guidelines (FLIE score 98; p-value 0.002).

CONCLUSIONS: Non adherence to guideline significantly increase the incidence of both acute and delayed chemotherapy CINV and associated with lower quality of life. In developed countries, oncology pharmacists can sustain guideline recommendation and providing patient-centered practice and lead in maintaining favored outcomes. However, in developing countries like Ethiopia, further efforts must be undertaken to improve guideline compliance. The result of this study have bold impact to call for actions in developing countries.