Antiemetic treatment in the emergency department: Patient opinions and expectations

Abstract

To determine patient expectations of antiemetic treatment in the ED. Survey of adult ED patients with nausea. Primary outcome: expectation of antiemetic treatment as symptoms being ‘totally gone’, ‘a lot less’, ‘a little less’ and ‘the same’. Secondary outcomes: comparison between expectations and symptom change when expectations were met; general views on indications for treatment, treatment satisfaction and reasons for additional medication use. Of 176 surveyed, treatment expectation was recorded by 165 (94%). These were: ‘totally gone’, ‘a lot less’ or ‘a little less’ for 60 (36%), 84 (51%) and 21 (13%), respectively. This pre-treatment nomination, was matched or exceeded by the reported level of symptom reduction at 30 min, for 43/87 (49%, 95% CI: 39–60) whose expectations were met, and 6/33 (18%, 95% CI: 7–35) whose were not. The majority (117/176, 66%) believed treatment should be reserved for moderate or severe nausea; 158/176 (90%) would accept treatment if offered; 130/165 (79%) expected a treatment effect by 30 min. Treatment satisfaction findings were similar to expectations being met. Further drug treatment at 30 min was desired by 29/120 (24%) who received an antiemetic drug. Most were improved, but believed additional drugs might help more. Of the 91 not wanting more treatment, most were improved and thought no more drugs were necessary. Most patients expected antiemetic treatment to make symptoms at least ‘a lot less’. Most also believe treatment should be reserved for moderate or severe nausea, and should take effect by 30 min.