The first version of the clinical practice guideline Nausea and vomiting was written in 1996 as part of the clinical practice guidelines for palliative care developed by the Comprehensive Cancer Centre Middle Netherlands. The guideline was revised in 2005 by A. de Graeff, M.B. Kuyper and G.M. Hesselmann and incorporated in the first edition of the guideline book by the Comprehensive Care Centres Netherlands. The guideline was again revised by A. de Graeff, C.M. Molenkamp and G.M. Hesselmann and the revised version was incorporated in the 2010 guideline book.
The current version was established in October 2013.
Objective A guideline is a set of recommendations to support the most important clinical problems in daily medical practice. This guideline is based, as much as possible, on scientific research or consensus.
Target group This guideline is intended for all professionals involved in the care of patients in the palliative phase who suffer from nausea and/or vomiting, such as general practitioners, nursing home physicians, medical specialists, nurses and dieticians.
Working method of the guideline development group A new expert group was formed for the purpose of the current revision; a mandate was obtained from the relevant scientific and professional associations to this end (see appendix 1, appendix 2 and appendix 4).
Clinical questions were formulated at the start of the revision. These questions followed from an inventory of clinical problems collected in the field from professionals and patients (representatives). The three most relevant clinical problems(see appendix 5)were further developed into clinical questions (see appendix 6).
In the chapter Management and treatment - symptomatic treatment - pharmacological treatment, the clinical questions form the basis of the new consensus text based on literature research; the guideline development group members consulted and used the literature familiar to them, supplemented with the outcomes of an SMILE literature search (Short Methodological Inventarisation of Literature and Evidence) by the CCCN. Each clinical (sub)question was assigned to one or more guideline development group members. The literature was summarised by the group members during a literature discussion; this formed the basis of the conclusions. Recommendations that were subsequently made in order to answer the clinical questions were the result of conclusions from literature combined with other considerations (context in daily practice).
Aside from the consensus-based text, all the existing guideline text was revised by experts (updated text).