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Karanasios S, Martzoukos N, Zampetakis N, Paleta D, Sampsonis T, Vasilogeorgis I, Gioftsos G. Cross-Cultural Adaptation and Measurement Properties of the Expectations for Treatment Scale (ETS) for Greek-Speaking Patients. Cureus 2023; 15:e46457. [PMID: 37927658 PMCID: PMC10623487 DOI: 10.7759/cureus.46457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Patients' treatment expectations are key factors influencing the health outcomes in various medical conditions. Using validated measures to capture these expectations has been strongly suggested to improve the prognosis of the health outcome and promote research investigations. The Expectations for Treatment Scale (ETS) is a well-established questionnaire designed to accurately measure treatment expectations in patients with low back pain; however, it is not available in Greek yet. We aimed to translate and cross-culturally adapt the ETS in Greek (ETS-Gr) and evaluate its reliability and validity in a Greek-speaking population with musculoskeletal disorders. Methods We followed published recommendations for the translation and cross-cultural adaptation process of the scale. Face and content validity were evaluated using interviews with patients and experts. Internal consistency, test-retest reliability, and measurement error were evaluated in 52 patients with musculoskeletal conditions. Results During forward and backward translation minor linguistic discrepancies were detected and effectively adapted for Greek-speaking patients. The ETS-Gr presented a high level of content validity (item content validity index: 0.88-1; and average scale content validity index: 0.90), acceptable internal consistency (Cronbach's alpha: 0.84), and excellent test-retest reliability (intraclass correlation coefficient: 0.96, 95% confidence interval: 0.93-0.98). Conclusions The ETS-Gr is a short, reliable, and valid instrument to measure pre-treatment expectations in patients with musculoskeletal disorders. Future investigations including other medical conditions are required.
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Affiliation(s)
| | | | | | - Danai Paleta
- Physiotherapy, University of West Attica, Athens, GRC
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2
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Xiao C, Wu A, Wang Y, Li T, Duan Y, Jiang Y, Shi L, Hong X, Geng W, Li J, Du J, Hu J, Cao J, Wei J. Development and psychometric validation of the hospitalized patients' expectations for treatment scale -patient version. Front Psychiatry 2023; 14:1201707. [PMID: 37377470 PMCID: PMC10291120 DOI: 10.3389/fpsyt.2023.1201707] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Objectives A general expectation measurement of inpatients across wards is needed in the patient safety management systems of general hospitals. This study developed and psychometrically validated a new scale fulfilling the requirements above: the Hospitalized Patients' Expectations for Treatment Scale-Patient version (HOPE-P). Methods A total of 35 experts and ten inpatients were interviewed during the formulation of the HOPE-P scale, which was initially designed with three dimensions: doctor-patient communication expectations, treatment outcome expectations, and disease management expectancy. We recruited 210 inpatients from a general hospital in China and explored the reliability, validity, and psychometric characteristics of the questionnaire. Item analysis, construct validity, internal consistency and 7-day test-retest reliability analysis were applied. Results Exploratory and confirmatory analyses supported a 2-dimension (doctor-patient communication expectation and treatment outcome expectation) structure with satisfactory model fit parameters (root mean square residual (RMR) = 0.035, a root-mean-square-error of approximation (RMSEA) = 0.072, comparative fit index (CFI) = 0.984, Tucker-Lewis index (TLI) = 0.970). Item analysis revealed an appropriate item design (r = 0.573-0.820). The scale exhibited good internal consistency, with Cronbach's α of 0.893, 0.761, and 0.919 for the overall scale, the doctor-patient communication expectation subscale, and the treatment outcome expectation subscale, respectively. The 7-day test-retest reliability was 0.782 (p < .001). Conclusion Our results indicated that the HOPE-P is a reliable and valid assessment tool to measure the expectations of general hospital inpatients, with a strong capacity to recognize patients' expectations regarding doctor-patient communication and treatment outcomes.
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Affiliation(s)
- Chunfeng Xiao
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Aoxue Wu
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Eight-Year Medical Doctor Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yufei Wang
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- 4+4 Medical Doctor Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tao Li
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanping Duan
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yinan Jiang
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lili Shi
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xia Hong
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenqi Geng
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiarui Li
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianhua Du
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiaojiao Hu
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinya Cao
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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3
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Crowder SL, Hoogland AI, Welniak TL, LaFranchise EA, Carpenter KM, Li D, Rotroff DM, Mariam A, Pierce CM, Extermann M, Kim RD, Tometich DB, Figueiredo JC, Muzaffar J, Bari S, Turner K, Weinstock GM, Jim HS. Metagenomics and chemotherapy-induced nausea: A roadmap for future research. Cancer 2022; 128:461-470. [PMID: 34643945 PMCID: PMC8776572 DOI: 10.1002/cncr.33892] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/06/2021] [Accepted: 08/13/2021] [Indexed: 02/03/2023]
Abstract
Uncontrolled chemotherapy-induced nausea and vomiting can reduce patients' quality of life and may result in premature discontinuation of chemotherapy. Although nausea and vomiting are commonly grouped together, research has shown that antiemetics are clinically effective against chemotherapy-induced vomiting (CIV) but less so against chemotherapy-induced nausea (CIN). Nausea remains a problem for up to 68% of patients who are prescribed guideline-consistent antiemetics. Despite the high prevalence of CIN, relatively little is known regarding its etiology independent of CIV. This review summarizes a metagenomics approach to the study and treatment of CIN with the goal of encouraging future research. Metagenomics focuses on genetic risk factors and encompasses both human (ie, host) and gut microbial genetic variation. Little work to date has focused on metagenomics as a putative biological mechanism of CIN. Metagenomics has the potential to be a powerful tool in advancing scientific understanding of CIN by identifying new biological pathways and intervention targets. The investigation of metagenomics in the context of well-established demographic, clinical, and patient-reported risk factors may help to identify patients at risk and facilitate the prevention and management of CIN.
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Affiliation(s)
| | | | | | | | | | - Daneng Li
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center
| | - Daniel M. Rotroff
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Arshiya Mariam
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | | | - Richard D. Kim
- Department of Hematology Oncology, Moffitt Cancer Center
| | | | | | - Jameel Muzaffar
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center
| | - Shahla Bari
- Department of Hematology Oncology, Moffitt Cancer Center
| | - Kea Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center
| | | | - Heather S.L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center
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4
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Shimokawa M, Hayashi T, Nishimura J, Satoh T, Fukunaga M, Matsui R, Tsuji Y, Mizuki F, Kogawa T. Pooled analysis of combination antiemetic therapy for chemotherapy-induced nausea and vomiting in patients with colorectal cancer treated with oxaliplatin-based chemotherapy of moderate emetic risk. BMC Cancer 2021; 21:1111. [PMID: 34656107 PMCID: PMC8520642 DOI: 10.1186/s12885-021-08860-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Among patients with colorectal cancer (CRC) treated with oxaliplatin (L-OHP)-based chemotherapy, delayed chemotherapy-induced nausea and vomiting (CINV) have not been well controlled. METHODS We pooled data from two prospective observational studies in Japan and one phase III clinical trial to assess whether delayed CINV could be controlled with a combination of three antiemetics adding a neurokinin-1 receptor antagonist and identified individual risk factors, using an inverse probability treatment-weighted analysis. RESULTS A total of 661 patients were evaluable in this study (median age: 64 years; 391 male, and 270 female). 3 antiemetics controlled delayed nausea (33.18% vs. 42.25%; p = 0.0510) and vomiting (4.15% vs. 16.08%; p < 0.0001) better than with 2 antiemetics. Female and 2 antiemetics were risk factors for both delayed nausea (female-odds ratio [OR]: 1.918; 95% confidence interval [CI]: 1.292-2.848; p = 0.0012; 2 antiemetics-OR: 1.485; 95% CI: 1.000-2.204; p = 0.0498) and delayed vomiting (female-OR: 2.735; 95% CI: 1.410-5.304; p = 0.0029; 2 antiemetics-OR: 4.551; 95% CI: 2.116-9.785; p = 0.0001). CONCLUSIONS Identifying individual risk factors can facilitate personalized treatments for delayed CINV. We recommend a 3-antiemetic combination prophylaxis for CRC patients treated with L-OHP-based chemotherapy, especially for female patients.
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Affiliation(s)
- Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan.
- Clinical Research Institute, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
| | - Toshinobu Hayashi
- Department of Pharmaceutical and Health Care Management, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan
| | - Junichi Nishimura
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Taroh Satoh
- Department of Frontier Science for Cancer and Chemotherapy, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mutsumi Fukunaga
- Department of surgery, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan
| | - Reiko Matsui
- Department of Pharmacy, National Cancer Center Hospital EastChiba, Kashiwa, Japan
| | - Yasushi Tsuji
- Department of Medical Oncology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Fumitaka Mizuki
- Center For Clinical Research, Yamaguchi University Hospital, Yamaguchi, Japan
| | - Takahiro Kogawa
- Division of Early Clinical Development for Cancer, Advanced Medical Development Center, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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5
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Devlin EJ, Whitford HS, Peoples AR, Morrow GR, Katragadda S, Giguere JK, Naqvi B, Roscoe J. Psychological predictors of chemotherapy-induced nausea in women with breast cancer: Expectancies and perceived susceptibility. Eur J Cancer Care (Engl) 2021; 30:e13488. [PMID: 34323340 PMCID: PMC9022467 DOI: 10.1111/ecc.13488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 01/21/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
Objective Chemotherapy‐induced nausea is challenging to predict and treat. Research indicates that pretreatment psychological variables including patients' perceptions of their susceptibility to nausea, expectancies of treatment‐related nausea and nausea history (i.e., motion sickness, morning sickness and baseline levels of nausea) may aid in predicting nausea severity during chemotherapy. However, this research is dated and limited in quantity. We investigated whether psychological variables could improve prediction of nausea severity to inform interventions targeting chemotherapy‐induced nausea. Methods In this secondary analysis, a subgroup of women receiving chemotherapy (for the first time) for breast cancer completed pretreatment measures: perceived nausea susceptibility, nausea expectancies, nausea history and baseline nausea. They rated subsequent nausea severity across 4‐days, during treatment and posttreatment in a self‐report diary. Structural Equation Modelling was used to explore associations. Results Across the women (N = 481), perceived nausea susceptibility predicted subsequent nausea severity (β = 0.16), but nausea expectancies did not (β = 0.05). Nausea history variables demonstrated small‐moderate associations with perceived susceptibility (β = 0.21–0.32) and negligible‐small associations with nausea expectancies (β = 0.07–0.14). Conclusion Perceived nausea susceptibility appears to capture patients' nausea history, to a degree, and is related to nausea severity during treatment. This is an important variable to include in pretreatment prediction of patients at risk of severe nausea.
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Affiliation(s)
- Elise J Devlin
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Hayley S Whitford
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anita R Peoples
- Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA.,Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Gary R Morrow
- Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA
| | - Sreedhar Katragadda
- Southeast Clinical Oncology Research Consortium, Winston Salem, North Carolina, USA
| | - Jeffrey K Giguere
- NCORP of the Carolinas (Greenville Health System), Greenville, South Carolina, USA
| | - Bilal Naqvi
- Wisconsin NCI Community Oncology Research Program, Marshfield, Wisconsin, USA
| | - Joseph Roscoe
- Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA
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6
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Okuyama A, Boku N, Higashi T. Real-world emetic risk of chemotherapy and the corresponding antiemetic therapy in Japan: A study based on a nationwide database. Cancer Rep (Hoboken) 2021; 5:e1482. [PMID: 34176233 PMCID: PMC8955058 DOI: 10.1002/cnr2.1482] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Chemotherapy-induced nausea and vomiting (CINV) is a major concern of patients with cancer, leading to suboptimal treatment. AIM This study assessed the emetic risk associated with intravenous and oral chemotherapy and the prophylactic antiemetic drugs by cancer type in a real-world setting. METHODS AND RESULTS We used the health services utilisation data for patients with cancer diagnosed in 2016. Patients aged at least 20 years at the time of diagnosis and who started their first course of chemotherapy were included. The emetic risk of chemotherapy was determined according to the cancer type and was classified based on clinical practice guidelines. The prescription of antiemetic drugs was assessed. Overall, 172 133 patients were evaluated, of whom 121 103 (70.4%) received intravenous chemotherapy. High-emetic-risk chemotherapy (HEC) was prescribed in 46 458 (27.0%) patients. HEC was prescribed most for patients with oesophageal cancer (80.3%), followed by malignant lymphoma (60.2%) and breast cancer (53.8%). Moderate-emetic-risk chemotherapy (MEC) was prescribed in 60 528 (35.2%) patients and was mostly prescribed for small cell lung cancer (59.9%). Meanwhile, more than 50% of the chemotherapy prescribed for patients with gastric, colorectal, and pancreatic cancer was low-emetic-risk chemotherapy. HEC was accompanied by three-drug antiemetic prophylaxis in more than 90% of patients with small cell lung, non-small cell lung, breast, and oesophageal cancer, whereas only 13.5% of patients with malignant lymphoma were administered CHOP (cyclophosphamide, doxorubicin, vincristine sulphate, and prednisolone) with prophylaxis. CONCLUSION The risk of CINV differs with cancer type. HEC was less prescribed compared with MEC. Most patients received the recommended anti-emetic prophylaxis.
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Affiliation(s)
- Ayako Okuyama
- Center for Cancer Control and Information ServicesNational Cancer CenterChuo‐kuJapan
| | - Narikazu Boku
- Division of Gastrointestinal Medical OncologyNational Cancer Center HospitalChuo‐kuJapan
| | - Takahiro Higashi
- Center for Cancer Control and Information ServicesNational Cancer CenterChuo‐kuJapan
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7
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Cockle S, Ogden J. Patients' expectations of cancer treatment and their perceived link to subsequent experiences: A qualitative study. Br J Health Psychol 2021; 27:267-282. [PMID: 34173698 DOI: 10.1111/bjhp.12544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 05/25/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Whilst much research has addressed patients' expectations and experiences of cancer treatment, little research has explored the association between these factors. The current qualitative study aimed to explore patients' beliefs about the relationship between their expectations of cancer treatment and their subsequent experiences. DESIGN Qualitative semi-structured interviews were conducted with sixteen individuals who had received cancer treatment. RESULTS Data were analysed using thematic analysis and illustrated that cancer treatment was experienced as a challenge that could be understood in terms of two themes: 'investing in treatment' reflecting trust in treatment and health care professionals and a sense that treatment was a necessary evil and 'encountering tensions or disconnects' illustrating the mismatch between expectations and experiences with patient reporting feeling unprepared, pleasantly surprised or shock. Transcending these themes was the notion of 'searching for stability and certainty' in terms of a desire for normality and a shift in focus between treatment process and outcome. Overall, disconnects were apparent between participants' expectations and experiences. However, due to their trust in treatment, participants were able to shift their focus between the treatment itself and future outcomes, to regain a sense of certainty. CONCLUSION Patients describe a complex relationship between expectations and experiences and are able to shift their focus between process and outcome to cope with the challenges they face.
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Affiliation(s)
- Sam Cockle
- School of Psychology, University of Surrey, Guildford, UK
| | - Jane Ogden
- School of Psychology, University of Surrey, Guildford, UK
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8
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Fruijtier AD, Visser LN, Bouwman FH, Lutz R, Schoonenboom N, Kalisvaart K, Hempenius L, Roks G, Boelaarts L, Claus JJ, Kleijer M, de Beer M, van der Flier WM, Smets EM. What patients want to know, and what we actually tell them: The ABIDE project. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12113. [PMID: 33344753 PMCID: PMC7744024 DOI: 10.1002/trc2.12113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/15/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND We studied to what degree and at whose initiative 25 informational topics, formerly identified as important, are discussed in diagnostic consultations. METHODS Audio recordings of clinician-patient consultations of 71 patients and 32 clinicians, collected in eight Dutch memory clinics, were independently content-coded by two coders. The coding scheme encompassed 25 informational topics. RESULTS Approximately half (Mdn = 12) of the 25 topics were discussed per patient during the diagnostic process, with a higher frequency among individuals receiving a dementia diagnosis (Mdn = 14) compared to others (Mdn = 11). Individual topics ranged from being discussed with 2/71 (3%) to 70/71 (99%) of patients. Patients and/or care partners rarely initiated topic discussion (10%). When they did, they often enquired about one of the least frequently addressed topics. CONCLUSION Most patients received information on approximately half of the important informational topics. Providing the topic list to patients and care partners beforehand could allow consultation preparation and stimulate participation.
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Affiliation(s)
- Agnetha D. Fruijtier
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
- Department of Medical PsychologyAcademic Medical CenterAmsterdam UMCAmsterdam Public Health Research InstituteAmsterdamthe Netherlands
| | - Leonie N.C. Visser
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
- Department of Medical PsychologyAcademic Medical CenterAmsterdam UMCAmsterdam Public Health Research InstituteAmsterdamthe Netherlands
| | - Femke H. Bouwman
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Rogier Lutz
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Niki Schoonenboom
- Department of Clinical GeriatricsSpaarne GasthuisHaarlemthe Netherlands
| | - Kees Kalisvaart
- Department of Clinical GeriatricsSpaarne GasthuisHaarlemthe Netherlands
| | | | - Gerwin Roks
- Department of NeurologyETZ HospitalTilburgthe Netherlands
| | - Leo Boelaarts
- Geriatric DepartmentNoordWest Ziekenhuis GroepAlkmaarthe Netherlands
| | - Jules J. Claus
- Department of NeurologyTergooi Hospital, Blaricumthe Netherlands
| | - Mariska Kleijer
- Department of NeurologyLangeLand ZiekenhuisZoetermeerthe Netherlands
| | - Marlijn de Beer
- Department of NeurologyReinier de Graaf GasthuisDelftthe Netherlands
| | - Wiesje M. van der Flier
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
- Department of Epidemiology and BiostatisticsAmsterdam NeuroscienceVU University Medical CenterAmsterdamthe Netherlands
| | - Ellen M.A. Smets
- Department of Medical PsychologyAcademic Medical CenterAmsterdam UMCAmsterdam Public Health Research InstituteAmsterdamthe Netherlands
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[Prevention and treatment of antineoplastic drug-induced nausea and vomiting in pediatric onco-hematology: An update]. Bull Cancer 2020; 107:800-812. [PMID: 32418660 DOI: 10.1016/j.bulcan.2020.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 03/25/2020] [Accepted: 03/29/2020] [Indexed: 11/21/2022]
Abstract
Antineoplastic drug induced nausea and vomiting are common adverse events in cancer care of paediatric patients ; therefore, prevention and management of these adverse events is a major concern for healthcare professionals. There are common features between paediatric and adult patients in terms of the emetogenic level depending on antineoplastic agents or about available medicines. However, there are also specificities for paediatric population including individual risk factors of emesis or nausea assessment for example. Knowledge relative to available medicines is also limited in the paediatric population, especially for recent medicines. This review aims to provide a comprehensive overview about antiemetics in paediatric oncology to clinicians and other healthcare professionals involved in paediatric cancer care. First of all, we describe physiopathological paediatric specificity, risk factors and clinical assessment of antineoplastic drug induced nausea and vomiting. Secondly, we focus on available medicines and also address the issue of complementary and alternative medicines.
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'Measuring up': A comparison of two response expectancy assessment formats completed by men treated with radiotherapy for prostate cancer. J Psychosom Res 2020; 132:109979. [PMID: 32146249 DOI: 10.1016/j.jpsychores.2020.109979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 02/25/2020] [Accepted: 02/27/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Response expectancies of cancer treatment toxicities are often, but not always, associated with subsequent experiences. A recent meta-analysis indicated that response expectancies, measured using different assessment formats, reveal different effect sizes, potentially explaining mixed outcomes. Utilizing a clinical sample, we compared 5-point assessments and visual analogue scales, as measures of response expectancies for the incidence and severity of subsequent toxicities. METHODS Four weeks pre-radiotherapy, 45 men with prostate cancer rated their response expectancies of the same 18 toxicities on 5-point assessments and visual analogue scales, presented in random order. Descriptors anchored each end of visual analogue scales and every point of 5-point assessments was labelled, including an 'unsure' midpoint. Toxicities were subsequently assessed 2-weeks into radiotherapy on 100-point visual analogue scales. RESULTS Across all toxicities, 17.5-62.8% of patients selected 'unsure' on 5-point assessments. No response expectancies were reported on 5-point assessments for 'blood in stools' or 'rectal urgency' yet 54.8%-64.3% of patients indicated response expectancies for these toxicities on visual analogue scales. Visual analogue scales and 5-point scales demonstrated small-to-moderate associations (r = 0.30-0.58) as measures of response expectancy incidence, but mostly large associations when visual analogue scales captured severity (r = 0.43-0.76). Response expectancies measured with visual analogue scales predicted more toxicities to a moderate degree or greater (68.8%) than 5-point assessments (37.5%). CONCLUSION This novel investigation demonstrated an 'unsure' midpoint is often selected, potentially reducing the sensitivity of 5-point assessments. Based on their associations, and outcomes, these assessment formats should be considered independent in response expectancy research of cancer treatment toxicities.
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11
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Mosa ASM, Hossain AM, Lavoie BJ, Yoo I. Patient-Related Risk Factors for Chemotherapy-Induced Nausea and Vomiting: A Systematic Review. Front Pharmacol 2020; 11:329. [PMID: 32296333 PMCID: PMC7138899 DOI: 10.3389/fphar.2020.00329] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 03/06/2020] [Indexed: 01/08/2023] Open
Abstract
Background Studies have reported that patient-related factors significantly impact the risk of Chemotherapy-Induced Nausea and Vomiting (CINV). The objective of this study was to analyze those risk factors of CINV through a systematic literature review. Methods We searched MEDLINE to identify articles that addressed patient-related risk factors of CINV through clinical studies. Results A total of 49 articles were selected for this study. A total of 28 patient-related risk-factors that significantly impact the risk of CINV were documented. Three factors are demographically related, 17 factors are intrinsic in nature and innate to patient's physiology or influenced by physiology, and eight factors are extrinsic in nature. At least five studies identified seven risk factors with notable summary odds ratio: history of nausea/vomiting (odds ratio: 3.13, 95% CI 2.40–4.07, p < 0.05), female sex (odds ratio: 2.79, 95% CI 2.26–3.44, p < 0.05), expectancy of CINV (odds ratio: 2.61, 95%CI 1.69–4.02, p < 0.05), younger age (odds ratio: 2.59, 95% CI 2.18–3.07, p < 0.05), anxiety (odds ratio: 2.57, 95% CI 1.94–3.40, p < 0.05), history of morning sickness (odds ratio: 1.97, 95% CI 1.46–2.65, p < 0.05), and low alcohol intake (odds ratio: 1.94, 95% CI 1.68–2.24, p < 0.05). Conclusions Oncologists can use these factors prior to the initiation of a chemotherapy regimen to identify patients at risk for CINV, in order to focus on more comprehensive antiemetic treatment options for those high-risk patients. This may enable better outcomes and avoid complications.
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Affiliation(s)
- Abu Saleh Mohammad Mosa
- Department of Health Management and Informatics, School of Medicine, University of Missouri, Columbia, MO, United States.,Informatics Institute, University of Missouri, Columbia, MO, United States.,Institute for Clinical and Translational Science, School of Medicine, University of Missouri, Columbia, MO, United States
| | - A Mosharraf Hossain
- Division of Hematology and Medical Oncology, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Beau James Lavoie
- Department of Health Management and Informatics, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Illhoi Yoo
- Department of Health Management and Informatics, School of Medicine, University of Missouri, Columbia, MO, United States.,Informatics Institute, University of Missouri, Columbia, MO, United States
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12
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Latest Update on Prevention of Acute Chemotherapy-Induced Nausea and Vomiting in Pediatric Cancer Patients. Curr Oncol Rep 2019; 21:89. [PMID: 31418119 PMCID: PMC6695477 DOI: 10.1007/s11912-019-0840-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE OF REVIEW Chemotherapy-induced nausea and vomiting (CINV) is a common cause of acute morbidity that impacts quality of life in children receiving cancer treatment. Here, we review the evolution of CINV prophylaxis guidelines in children, with an emphasis on the literature published in the last 5 years, to bring the reader up to date. RECENT FINDINGS Recent studies have led to the adoption of the "triple therapy" regimen of antiemetic prophylaxis (a 5-HT3 antagonist, dexamethasone, and a neurokinin-1 antagonist) as the backbone of recommendations for the prevention of CINV in children. Areas of new data include the addition of aprepitant and inclusion of palonosetron as a non-inferior 5-HT3 antagonist. In addition, there are emerging pediatric data informing patient-derived risk factors associated with CINV risk and classification of antineoplastic drugs based on emetogenicity. Several recent pediatric studies have shaped published guidelines for CINV prophylaxis in children.
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13
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Meissner K, Talsky N, Olliges E, Jacob C, Stötzer OJ, Salat C, Braun M, Flondor R. Individual Factors Contributing to Nausea in First-Time Chemotherapy Patients: A Prospective Cohort Study. Front Pharmacol 2019; 10:410. [PMID: 31133847 PMCID: PMC6524707 DOI: 10.3389/fphar.2019.00410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 04/01/2019] [Indexed: 12/13/2022] Open
Abstract
Objective The expectation of developing side effects can enhance the likelihood to develop them – a phenomenon referred to as nocebo effect. Whether nocebo effects can be reduced by lowering negative expectancies, is not clear. The aim of this prospective study was to learn more about the factors contributing to nausea expectancy and their potential role in actual occurrence of nausea in patients undergoing chemotherapy for the first time in their life. Methods Patients scheduled for moderately emetogenic chemotherapeutic regimens filled in questionnaires to assess state anxiety and quality of life and to rate the expectancy of nausea as a side effect of chemotherapy. Patient diaries were used to monitor the severity of post-chemotherapy nausea in the 4 days following chemotherapy administration. Bivariate analyses complemented by multiple regression analyses were performed to identify the relationship between nausea expectation and nausea occurrence. Results 121 female patients (mean age 53 years) with completed questionnaires were included in the analyses. The majority of the patients had a diagnosis of breast cancer (86%). The two main sources for nausea expectancy were positive history of nausea in other situations and state anxiety. Patients with high expectancy levels (first quartile) experienced greater nausea than those with lower expectancy levels. Bivariate analyses revealed a weak but non-significant association between nausea expectation and post-chemotherapy nausea. When controlling for age, type of cancer, history of nausea, state and trait anxiety, and global quality of life, positive history of nausea (OR = 2.592; 95% CI, 1.0 to 6.67; p < 0.05), younger age (OR = 0.95; 95% CI, 0.92 to 0.99; p < 0.05), and a lower quality of life (OR = 0.97; 95% CI, 0.94 to 1.0; p < 0.05), but not nausea expectancy (OR = 1.014; 95% CI, 0.51 to 2.02; p = 0.969), predicted the occurrence of post-chemotherapy nausea. Conclusion In this female cohort, younger patients with lower initial quality of life and a positive history of nausea were at higher risk to develop nausea after first time chemotherapy. These patients may benefit from psychological co-interventions that aim to enhance quality of life.
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Affiliation(s)
- Karin Meissner
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany.,Division of Health Promotion, Coburg University of Applied Sciences, Coburg, Germany
| | - Nicola Talsky
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Elisabeth Olliges
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany.,Division of Health Promotion, Coburg University of Applied Sciences, Coburg, Germany
| | - Carmen Jacob
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany.,Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Oliver J Stötzer
- Haematology and Oncology, Outpatient Cancer Care Center, Munich, Germany
| | - Christoph Salat
- Haematology and Oncology, Outpatient Cancer Care Center, Munich, Germany
| | - Michael Braun
- Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany
| | - Raluca Flondor
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
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14
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Peoples AR, Culakova E, Heckler CE, Shayne M, O'Connor TL, Kirshner JJ, Bushunow PW, Morrow GR, Roscoe JA. Positive effects of acupressure bands combined with relaxation music/instructions on patients most at risk for chemotherapy-induced nausea. Support Care Cancer 2019; 27:4597-4605. [PMID: 30929028 DOI: 10.1007/s00520-019-04736-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 03/07/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Research by our group has shown that acupressure bands are efficacious in reducing chemotherapy-induced nausea (CIN) for breast cancer patients who expect nausea, and that their effectiveness in controlling CIN can largely be accounted for by patients' expectations of efficacy, i.e., a placebo effect. The present research examined if the effectiveness of acupressure bands could be enhanced by boosting patients' expectation of the bands' efficacy. METHODS Two hundred forty-two chemotherapy-naïve patients with breast cancer who expected nausea were randomized. Arms 1 and 2 received acupressure bands, plus a relaxation MP3 and written handout that were either expectancy-enhancing (arm 1) or expectancy-neutral (arm 2). Arm 3 was the control without bands or MP3 and received standard care. All participants received guideline-specified antiemetics. RESULTS Peak CIN for arms 1, 2, and 3 on a 1-7 scale was 3.52, 3.55, and 3.87, respectively (p = 0.46). Because no differences were observed between arms 1 and 2 (primary analysis), we combined these two arms (intervention) and compared them to controls for the following analyses. A significant interaction was found between intervention/control and receiving doxorubicin-based chemotherapy (yes/no) and pre-treatment anxiety (high/low). Intervention patients receiving doxorubicin had lower peak CIN than controls (3.62 vs. 4.38; p = 0.02). Similarly, intervention patients with high pre-treatment anxiety had a lower peak CIN than controls (3.62 vs. 4.62; p = 0.01). CONCLUSIONS In breast cancer patients undergoing chemotherapy and having high CIN expectation, acupressure bands combined with a relaxation recording were effective in reducing CIN for patients who received doxorubicin or had high anxiety.
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Affiliation(s)
- Anita R Peoples
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
| | - Eva Culakova
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
| | - Charles E Heckler
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle Shayne
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Tracey L O'Connor
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Jeffrey J Kirshner
- Hematology-Oncology Associates of Central New York, East Syracuse, NY, USA
| | | | - Gary R Morrow
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
| | - Joseph A Roscoe
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
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15
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Shiomi M, Takada T, Tanaka Y, Yajima K, Isomoto A, Sakamoto M, Otori K. Clinical factors associated with the occurrence of nausea and vomiting in type 2 diabetes patients treated with glucagon-like peptide-1 receptor agonists. J Diabetes Investig 2019; 10:408-417. [PMID: 30033675 PMCID: PMC6400150 DOI: 10.1111/jdi.12900] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 07/14/2018] [Accepted: 07/19/2018] [Indexed: 12/19/2022] Open
Abstract
AIMS/INTRODUCTION Research has proved a correlation between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and gastrointestinal adverse events. Predominantly, nausea and vomiting are frequent gastrointestinal adverse events that lead to the discontinuation of GLP-1 RAs treatment. The present study aims to investigate clinical factors related to nausea and vomiting, considering diabetic complications and agents affecting the gastrointestinal tract, such as proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs), in patients with type 2 diabetes treated with GLP-1 RAs. MATERIALS AND METHODS This retrospective study included Japanese patients with type 2 diabetes who started receiving GLP-1 RAs therapy. We assessed nausea and vomiting up to 48 weeks after treatment with GLP-1 RAs and used Fine-Gray's proportional hazards model to investigate clinical factors related to nausea and vomiting. RESULTS A total of 130 patients were included in this study. Patients with PPIs or H2RAs showed a higher incidence of nausea and vomiting at 48 weeks than those without PPIs or H2RAs. The multivariate analysis revealed that female sex, retinopathy and treatment with PPIs or H2RAs were statistically significant risk factors for nausea and vomiting. Analysis of patients without PPIs or H2RAs showed that female sex and retinopathy were also statistically significant risk factors. CONCLUSIONS The present study showed a significant correlation of PPIs or H2RAs, female sex, and diabetic retinopathy with nausea and vomiting in patients with type 2 diabetes treated with GLP-1 RAs. Hence, the occurrence of nausea and vomiting in patients with these factors warrants attention.
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Affiliation(s)
- Megumi Shiomi
- Department of Clinical PharmacySchool of PharmacyKitasato UniversityTokyoJapan
- Department of PharmacyKitasato University Medical CenterSaitamaJapan
| | - Tesshu Takada
- Department of Endocrinology and MetabolismKitasato University Medical CenterSaitamaJapan
| | - Yoichi Tanaka
- Department of Clinical PharmacySchool of PharmacyKitasato UniversityTokyoJapan
- Department of PharmacyKitasato University Medical CenterSaitamaJapan
| | - Keiko Yajima
- Department of PharmacyKitasato University Medical CenterSaitamaJapan
| | - Akira Isomoto
- Department of PharmacyKitasato University Medical CenterSaitamaJapan
| | - Masaki Sakamoto
- Department of PharmacyKitasato University Medical CenterSaitamaJapan
| | - Katsuya Otori
- Department of Clinical PharmacySchool of PharmacyKitasato UniversityTokyoJapan
- Department of PharmacyKitasato University Medical CenterSaitamaJapan
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16
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Fletcher C, Wilson C, Hutchinson AD, Grunfeld EA. The relationship between anticipated response and subsequent experience of cancer treatment-related side effects: A meta-analysis comparing effects before and after treatment exposure. Cancer Treat Rev 2018; 68:86-93. [DOI: 10.1016/j.ctrv.2018.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 06/13/2018] [Accepted: 06/14/2018] [Indexed: 10/28/2022]
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17
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Slimano F, Netzer F, Borget I, Lemare F, Besse B. Olanzapine as antiemetic drug in oncology: a retrospective study in non-responders to standard antiemetic therapy. Int J Clin Pharm 2018; 40:1265-1271. [PMID: 29744791 DOI: 10.1007/s11096-018-0649-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 05/04/2018] [Indexed: 12/13/2022]
Abstract
Background The role of olanzapine in the treatment of chemotherapy-induced nausea and vomiting (CINV) in addition to the antiemetic therapeutic combination with aprepitant, setrons, and corticosteroids has not been well defined. Objective To investigate the effectiveness of the addition of olanzapine to a standard triplet therapy for the prevention of CINV in patients who experienced CINV during their first chemotherapy course, despite receiving a well-managed prevention protocol. Setting One comprehensive cancer centre in France. Method In a retrospective study with comparator, patients with a high risk of emesis were assigned to two groups during two different 6-month periods, before and after the introduction of olanzapine in clinical practice, respectively. In the olanzapine group, the antiemetic protocol for the second course of chemotherapy was reinforced by the addition of olanzapine at 5 mg/day from day 1 to 5 in contrast with the control group. Main outcome measure The proportion of patients who experienced neither nausea nor emesis during the delayed phase (24-120 h). Results The 25 patients in each group exhibited comparable characteristics and emetic chemotherapy level. During the first course, no significant difference was observed. During the second course, nausea and vomiting were ameliorated in 12 patients in the olanzapine group and 4 patients in the control group (p < 0.05). Nausea (12 vs. 4, p < 0.05) and vomiting (18 vs. 11, p < 0.05) also significantly improved. In the OLZ group, no adverse event was linked to olanzapine use. Conclusion The addition of olanzapine was observed to effectively restore CINV prevention in patients who did not respond to standard antiemetic therapy.
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Affiliation(s)
- Florian Slimano
- Department of Clinical Pharmacy, Gustave Roussy Cancer Campus, 114 rue Edouard-Vaillant, 94805, Villejuif, France.
- Faculty of Pharmacy, Reims University, 51 rue Cognacq-Jay, 51100, Reims, France.
| | - Florence Netzer
- Department of Clinical Pharmacy, Gustave Roussy Cancer Campus, 114 rue Edouard-Vaillant, 94805, Villejuif, France
| | - Isabelle Borget
- Department of Biostatistic and Epidemiology, Gustave Roussy Cancer Campus, and INSERM U 1018, Paris-Sud, Paris-Saclay University, Châtenay-Malabry, France
- GRADES, Paris-Sud, Paris-Saclay University, 5 Rue Jean-Baptiste Clément, 92290, Châtenay-Malabry, France
| | - François Lemare
- Department of Clinical Pharmacy, Gustave Roussy Cancer Campus, 114 rue Edouard-Vaillant, 94805, Villejuif, France
- Faculty of Pharmacy, Paris Descartes University, 4 rue de l'Observatoire, 75006, Paris, France
| | - Benjamin Besse
- Department of Medical Oncology, Gustave Roussy Cancer Campus, 114 rue Edouard-Vaillant, 94805, Villejuif, France
- Faculty of Medicine, Paris-Sud, Paris-Saclay University, 63 rue Gabriel Péri, 94276, Le Kremlin-Bicêtre Cedex, France
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18
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Clemons M. Guidelines versus individualized care for the management of CINV. Support Care Cancer 2018; 26:11-17. [PMID: 29556809 PMCID: PMC5876263 DOI: 10.1007/s00520-018-4115-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 02/15/2018] [Indexed: 11/30/2022]
Abstract
Numerous groups have published guidelines for the prevention and management of chemotherapy-induced nausea and vomiting (CINV). The current management of CINV, however, remains suboptimal, due in part to poor adherence to existing antiemetic guidelines. Challenges in clinical trial design have also slowed progress and complicated the selection of optimal antiemetic therapy. In addition, patient-specific characteristics and factors are not included in current CINV guidelines and are an important contributor to an individual’s risk for nausea and vomiting. CINV risk prediction algorithms have now emerged and provide the opportunity to individualize antiemetic prophylaxis. Further studies are underway to examine the precise role for risk model-guided antiemetic prophylaxis in patients with cancer.
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Affiliation(s)
- Mark Clemons
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada.
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19
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Devlin EJ, Denson LA, Whitford HS. Cancer Treatment Side Effects: A Meta-analysis of the Relationship Between Response Expectancies and Experience. J Pain Symptom Manage 2017; 54:245-258.e2. [PMID: 28533160 DOI: 10.1016/j.jpainsymman.2017.03.017] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 02/22/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
Abstract
CONTEXT Although previous research has, overall, suggested a moderate relationship between response expectancies (REs) and cancer treatment-related side effects, empirical results have been mixed. OBJECTIVES We aimed to further explore these relationships, hypothesizing that REs would predict subsequent toxicities with the inclusion of more recent studies, across a broader range of side effects, while incorporating the impact of potential moderators including patients' experience with treatment and measurement methods. We further investigated the impact of REs across individual toxicities. METHODS A systematic search and analysis were conducted across four databases (PsychInfo, PubMed, CINAHL, and Embase) and reference lists, from 1985 to February 2016. This provided 27 eligible studies with 4474 participants, through which the main analysis, moderator analyses, and individual side-effect analyses were explored. RESULTS REs were moderately related to side effects overall (r = 0.26), and effect sizes were significantly influenced by sample diagnostic homogeneity, whereas differences between type and timing of measurement showed trends. Of the 16 toxicities examined, 15 demonstrated significant relationships between REs and side-effect experience, with hair loss (r = 0.48) the strongest. No clear difference emerged between objective and subjective side effects; however, significant differences across individual toxicities were revealed. CONCLUSION Findings support a relationship between REs and a wide range of subsequent side effects, yet differences between individual RE-toxicity associations emerged. These findings provide direction for the measurement of side effects and REs and support REs as potential targets for intervention during the informed consent process.
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Affiliation(s)
- Elise J Devlin
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Linley A Denson
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Hayley S Whitford
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia; Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
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20
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The Benefit of Pro Re Nata Antiemetics Provided With Guideline-Consistent Antiemetics in Delayed Nausea Control. Cancer Nurs 2017; 41:E49-E57. [PMID: 28418944 DOI: 10.1097/ncc.0000000000000484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Delayed nausea after chemotherapy remains a symptom of interest. Clinicians often provide additional and/or pro re nata (p.r.n.) antiemetics with guideline-consistent antiemetics in an attempt to achieve further symptom control. Whether the usage of additional and/or p.r.n. antiemetics provide added benefit remains as a question. OBJECTIVE The purpose of this study was to determine the benefit of providing additional antiemetics and/or p.r.n. antiemetics with guideline-consistent antiemetics in the control of nausea, functioning, and quality of life (QOL). METHODS A secondary data analysis of 143 breast cancer patients who received guideline-consistent antiemetics for anthracycline and cyclophosphamide chemotherapy was conducted. Instruments included vomiting frequency and nausea intensity items of the Multinational Association of Supportive Care in Cancer Antiemesis Tool and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30. RESULTS Providing p.r.n. antiemetics alleviated the incidence of significant nausea (intensity, ≥3) in the delayed phase. The experience of nausea contributed to symptom incidence in the next phase and cycle. The intensity of delayed nausea demonstrated a moderate negative correlation with physical and role functioning and global health/QOL. CONCLUSION Providing patients with strategies to further control nausea (p.r.n. antiemetics) in addition to guideline-consistent antiemetics is recommended for practice. Because the nausea experience contributes to symptom incidence in the next phase and cycle and because the nausea intensity demonstrated a significant relationship with function and global health/QOL, proactive supportive approaches are strongly recommended. IMPLICATIONS FOR PRACTICE Delayed nausea control may be improved by adhering to guideline-consistent antiemetics and using p.r.n. antiemetics. Delayed nausea control would contribute to patients' functioning and QOL.
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21
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Mukoyama N, Yoshimi A, Goto A, Kotani H, Ishikawa K, Miyazaki N, Miyazaki M, Yamada K, Kikkawa F, Hasegawa Y, Ozaki N, Noda Y. An Analysis of Behavioral and Genetic Risk Factors for Chemotherapy-Induced Nausea and Vomiting in Japanese Subjects. Biol Pharm Bull 2017; 39:1852-1858. [PMID: 27803457 DOI: 10.1248/bpb.b16-00440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There are individual differences in the frequency of chemotherapy-induced nausea and vomiting (CINV) in cancer patients. We investigated the individual variability in susceptibility to CINV with focus on both behavioral factors and genetic factors in Japanese cancer patients. We performed a prospective study to investigate the association between patient attributes (backgrounds and habits as well as gene polymorphisms) and anorexia, nausea, or vomiting in 55 Japanese cancer patients undergoing chemotherapy at Nagoya University Hospital. We found that gender (female), use of non-steroidal anti-inflammatory drugs, susceptibility to motion sickness, and anxiety were associated with the frequency of CINV. Gene polymorphisms of rs1076560 (dopamine D2 receptor gene), rs6766410 (serotonin 5-HT3C receptor gene) and rs4680 (catechol-O-methyltransferase gene) were also associated. Our data suggest that these attributes may thus be risk factors for CINV. Our results provide novel information that can be used to predict the incidence of CINV in Japanese patients undergoing chemotherapy; this can help provide a substantial improvement in supportive care for patients with different types of cancer.
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Affiliation(s)
- Naoki Mukoyama
- Division of Clinical Sciences and Neuropsychopharmacology, Faculty and Graduate School of Pharmacy, Meijo University
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22
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Moysés AMB, Durant LC, Almeida AMD, Gozzo TDO. Integrative review of factors related to the nursing diagnosis nausea during antineoplastic chemotherapy. Rev Lat Am Enfermagem 2016; 24:e2812. [PMID: 27737380 PMCID: PMC5068908 DOI: 10.1590/1518-8345.1176.2812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 06/15/2016] [Indexed: 11/21/2022] Open
Abstract
Objective to identify factors related to the nursing diagnosis nausea among cancer patients undergoing chemotherapy. Method integrative review conducted in four electronic databases (PUBMED, EMBASE, CINAHL and LILACS) using the key words: neoplasia, antineoplastic agents and nausea. Results only 30 out of 1,258 papers identified met the inclusion criteria. The most frequent related factors were: being younger than 50 years old, motion sickness, being a woman, emetogenic potential of the chemotherapy, anxiety, conditioned stimulus, and expecting nausea after treatment. Conclusion this review's findings, coupled with the incidence of nausea among cancer patients undergoing chemotherapy, reveal an important difference between evidence found and that used by NANDA International, Inc. Even though it provides an appropriate definition of related factors, it does not mention chemotherapy, despite the various studies addressing the topic using different designs and presenting various objectives and outcomes.
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Affiliation(s)
- Aline Maria Bonini Moysés
- MSc, RN, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Lais Corsino Durant
- Master's student, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Ana Maria de Almeida
- PHD, Associate Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Thais de Oliveira Gozzo
- PHD, Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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23
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Controlling chemotherapy-induced nausea requires further improvement: symptom experience and risk factors among Korean patients. Support Care Cancer 2016; 24:3379-89. [DOI: 10.1007/s00520-016-3146-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 02/22/2016] [Indexed: 11/25/2022]
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Mizuno M, Hiura M, Kikkawa F, Numa F, Yaegashi N, Narahara H, Aoki D, Kimura E, Kato H, Shimokawa M, Sugiyama T, Kamura T. A prospective observational study on chemotherapy-induced nausea and vomiting (CINV) in patients with gynecologic cancer by the CINV Study Group of Japan. Gynecol Oncol 2016; 140:559-64. [PMID: 26748216 DOI: 10.1016/j.ygyno.2015.12.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 12/26/2015] [Accepted: 12/30/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study was performed to investigate the occurrence of and risk factors for chemotherapy-induced nausea and vomiting (CINV) in patients with gynecologic cancer. METHODS In total, 214 patients with gynecologic cancer who underwent highly emetogenic (HEC) or moderately emetogenic chemotherapy (MEC) were evaluated. We investigated the relationship between CINV and clinical factors and the accuracy of estimation of CINV by medical staff in the acute and late phases. Vomiting was evaluated in terms of frequency, and nausea was evaluated with a 100-mm visual analog scale on days 1 to 7. We also analyzed the risk factors and changes in CINV over time using a generalized linear mixed (GLM) model. RESULTS The multivariate analysis revealed no significant risk factors for acute CINV. The independent risk factors for delayed nausea were a morning sickness history (odds ratio [OR], 2.687; 95% confidence interval [95% CI], 1.450-4.976; p=0.0017), age (each 1-year increment) (OR, 0.97; 95% CI, 0.944-0.996; p=0.0235), and HEC (OR, 2.134; 95% CI, 1.039-4.383; p=0.0391). The GLM model demonstrated that the independent factors affecting nausea were significant morning sickness (p=0.0101) and HEC (p=0.0136). These data also showed more severe nausea from days 3 to 5, but the negative predictive value for estimation of delayed nausea by medical staff was 57.8%. CONCLUSION Our data suggest that improvement of preventive antiemetic administration is needed for patients with risk factors to manage delayed CINV caused by HEC and by MEC.
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Affiliation(s)
- Mika Mizuno
- Nagoya University Graduate School of Medicine, Japan.
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25
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Vanbockstael J, Coquan E, Gouerant S, Allouache D, Faveyrial A, Noal S, Delcambre C, Galais MP, Héron JF, Lefebvre AC, Sevin E, Hrab I, Polycarpe F, André M, Kaluzinski L, Gervais R, Gunzer K, Vié B, Saucier G, Lemenand N, Grellard JM, Clarisse B, Dugué AE, Joly F. How to improve the prevention of chemotherapy-induced nausea and vomiting? The French NAVI study. Support Care Cancer 2015; 24:1131-8. [PMID: 26268784 DOI: 10.1007/s00520-015-2882-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 07/29/2015] [Indexed: 01/30/2023]
Abstract
PURPOSE Chemotherapy-induced nausea and vomiting (CINV) still remain frequent. The procedure for announcing the diagnosis (PAD) was an emblematic measure of the first French Plan Cancer aiming at providing patients with time to listen, information after cancer diagnosis, and discussion on treatments and their side effects. We aimed at assessing the risk factors of CINV, focusing on patients' satisfaction with the PAD. METHODS This prospective multicentre study assessed the frequency and intensity of CINV among chemonaïve patients during the first cycle of treatment. CINV was defined by ≥1 emetic episode or reported nausea intensity ≥3 on a 0-10 scale. Multivariate analysis was used to identify factors related to global CINV onset including satisfaction with the PAD (satisfaction score ≥the median on a 0-10 scale). RESULTS Data from 291 patients (women, 85.2%; mean age, 57 years) were analyzed. Most patients (69.4%) received highly emetogenic chemotherapy regimens and 77.7% received antiemetic drugs consistent with international guidelines. Acute, delayed and overall CINV were experienced by 40.4, 34.8 and 52.4% of patients, respectively. Sixty-seven per cent of patients were satisfied with the PAD. No relation was noted between PAD satisfaction and CINV onset. The nausea and vomiting dimension of the QLQ-C30 questionnaire before chemotherapy (OR 3.62), motion sickness history (OR 2.73), highly emetogenic CT (OR 2.73), anxiety (OR 1.99) and younger age (OR 1.96) were independent predictive factors. CONCLUSIONS Although patients were mostly satisfied with the PAD, half of them experienced CINV. A state of anxiety could be identified during the PAD to be managed.
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Affiliation(s)
| | - Elodie Coquan
- Centre François Baclesse, Department of Oncology, Caen, France.
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France.
| | - Sophie Gouerant
- Rouen University Hospital, Department of Oncology, Rouen, France
- Centre Henri Becquerel, Department of Oncology, Rouen, France
| | | | | | - Sabine Noal
- Centre François Baclesse, Department of Oncology, Caen, France
| | | | | | | | | | - Emmanuel Sevin
- Centre François Baclesse, Department of Oncology, Caen, France
| | - Ioana Hrab
- Centre François Baclesse, Department of Oncology, Caen, France
| | | | - Michel André
- Hôpital Monod, Department of Oncology, Flers, France
| | - Laure Kaluzinski
- Centre Hospitalier Public du Cotentin, Department of Oncology, Cherbourg-Octeville, France
| | - Radj Gervais
- Centre François Baclesse, Department of Oncology, Caen, France
| | | | - Brigitte Vié
- Clinique Armoricaine, Department of Oncology, Saint-Brieuc, France
| | | | - Noëmie Lemenand
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
| | - Jean-Michel Grellard
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
| | - Bénédicte Clarisse
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
| | - Audrey Emmanuelle Dugué
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
| | - Florence Joly
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
- Université de Caen Basse-Normandie, UMR-S1077, Caen, France
- INSERM, U1086, Caen, France
- CHU de Caen, Department of Oncology, Caen, France
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Tamura K, Aiba K, Saeki T, Nakanishi Y, Kamura T, Baba H, Yoshida K, Yamamoto N, Kitagawa Y, Maehara Y, Shimokawa M, Hirata K, Kitajima M. Testing the effectiveness of antiemetic guidelines: results of a prospective registry by the CINV Study Group of Japan. Int J Clin Oncol 2015; 20:855-65. [PMID: 25681876 DOI: 10.1007/s10147-015-0786-7] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 01/17/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many cancer patients suffer from the common side effect of chemotherapy-induced nausea and vomiting (CINV). Guidelines recommend a combination of two prophylactic antiemetics for moderately emetogenic chemotherapy (MEC) and three for highly emetogenic chemotherapy (HEC) and certain MEC regimens. METHODS This multicenter, prospective, observational study analyzed data for 1,910 patients in Japan scheduled for MEC or HEC. Use of antiemetic prophylaxis in relation to type of chemotherapy, incidences of and risk factors for nausea, vomiting, and acute versus delayed CINV, and estimated incidence of CINV by staff were analyzed using Fisher's exact test and multivariate logistic regression. The patients recorded the incidence of CINV and severity of nausea by visual analogue scales daily for 7 days after receiving chemotherapy. RESULTS A total of 240 (20.1 %) HEC and 476 MEC patients (66.6 %) received 2 antiemetics, compared with 883 (73.9 %) and 200 (28.0 %), respectively, who received 3 antiemetics. Approximately 74 % of HEC and 95 % of MEC patients received antiemetic therapy in compliance with guidelines. Acute nausea and vomiting were well controlled, but high incidences of delayed nausea occurred in both HEC and MEC patients. Delayed vomiting (p < 0.0001) was significantly less frequent in patients receiving three compared with 2 antiemetics. Female sex was a major risk factor for CINV. Medical staff tended to overestimate the incidence of CINV. Among HEC regimens, the incidence of CINV and the degree of nausea on day 1 of anthracycline-cyclophosphamide combination therapy were higher than with a cisplatin-based regimen. CONCLUSIONS Adherence to antiemetic guidelines effectively controls vomiting but is less effective against delayed nausea in HEC and MEC patients. Identification of individual risk factors, such as female sex, will assist in the development of personalized treatments for CINV. More intensive antiemetic therapy or a different modality of prophylaxis should be considered for the control of acute CINV in an anthracycline-cyclophosphamide regimen.
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Affiliation(s)
- Kazuo Tamura
- Division of Medical Oncology, Hematology and Infectious Diseases, Department of Medicine, School of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Fukuoko, 814-0180, Japan.
| | - Keisuke Aiba
- Division of Clinical Oncology/Hematology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Toshiaki Saeki
- Breast Oncology Service, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Yoichi Nakanishi
- Research Institute for Diseases of the Chest, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Fukuoka, 812-8582, Japan
| | - Toshiharu Kamura
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Kumamoto University, 1-1-1, Honjomachi, Chuo-ku, Kumamoto, Kumamoto, 860-0811, Japan
| | - Kazuhiro Yoshida
- Department of Surgical Oncology, Gifu University, 1-1 Yanagito, Gifu, Gifu, 501-1194, Japan
| | - Nobuyuki Yamamoto
- Division of Thoracic Oncology, Shizuoka Cancer Center, 1007, Nagaizumicho, Sunto-gun, Shizuoka, 411-0934, Japan
| | - Yuko Kitagawa
- Department of Surgery, School of Medicine, Keio University, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-0016, Japan
| | - Yoshihiko Maehara
- Department of Surgery and Science, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Fukuoka, 812-8582, Japan
| | - Mototsugu Shimokawa
- Department of Cancer Information Research, National Hospital Organization Kyushu Cancer Center, 3-1-1, Notame, Minami-ku, Fukuoka, Fukuoka, 811-1395, Japan
| | - Koichi Hirata
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, S1 W17, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
| | - Masaki Kitajima
- International University of Health and Welfare, 2600-1 Kitakanemaru, Ohtawara, Tochigi, 324-8501, Japan
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Ngampramuan S, Cerri M, Del Vecchio F, Corrigan JJ, Kamphee A, Dragic AS, Rudd JA, Romanovsky AA, Nalivaiko E. Thermoregulatory correlates of nausea in rats and musk shrews. Oncotarget 2015; 5:1565-75. [PMID: 24728971 PMCID: PMC4039232 DOI: 10.18632/oncotarget.1732] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Nausea is a prominent symptom and major cause of complaint for patients receiving anticancer chemo- or radiation therapy. The arsenal of anti-nausea drugs is limited, and their efficacy is questionable. Currently, the development of new compounds with anti-nausea activity is hampered by the lack of physiological correlates of nausea. Physiological correlates are needed because common laboratory rodents lack the vomiting reflex. Furthermore, nausea does not always lead to vomiting. Here, we report the results of studies conducted in four research centers to investigate whether nausea is associated with any specific thermoregulatory symptoms. Two species were studied: the laboratory rat, which has no vomiting reflex, and the house musk shrew (Suncus murinus), which does have a vomiting reflex. In rats, motion sickness was induced by rotating them in their individual cages in the horizontal plane (0.75 Hz, 40 min) and confirmed by reduced food consumption at the onset of dark (active) phase. In 100% of rats tested at three centers, post-rotational sickness was associated with marked (~1.5°C) hypothermia, which was associated with a short-lasting tail-skin vasodilation (skin temperature increased by ~4°C). Pretreatment with ondansetron, a serotonin 5-HT3 receptor antagonist, which is used to treat nausea in patients in chemo- or radiation therapy, attenuated hypothermia by ~30%. In shrews, motion sickness was induced by a cyclical back-and-forth motion (4 cm, 1 Hz, 15 min) and confirmed by the presence of retching and vomiting. In this model, sickness was also accompanied by marked hypothermia (~2°C). Like in rats, the hypothermic response was preceded by transient tail-skin vasodilation. In conclusion, motion sickness is accompanied by hypothermia that involves both autonomic and thermoeffector mechanisms: tail-skin vasodilation and possibly reduction of the interscapular brown adipose tissue activity. These thermoregulatory symptoms may serve as physiological correlates of nausea.
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Affiliation(s)
- Sukonthar Ngampramuan
- Research Center for Neuroscience and Institute of Molecular Bioscience, Mahidol University, Bangkok, Thailand
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Ito S, Tsukiyama I, Ando M, Katakami M, Hamanaka R, Kosaka K, Matsubara A, Nishimura M, Tanaka H, Asai N, Yokoe N, Takahashi A, Baba K, Matsuura K, Yamaguchi E, Kubo A. Therapeutic and preventive antiemetic effect of aprepitant in Japanese patients with thoracic malignancies who truly need it. Support Care Cancer 2014; 23:905-12. [PMID: 25223352 DOI: 10.1007/s00520-014-2430-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 09/02/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE Neurokinin-1 (NK-1) receptor antagonist is recommended for chemotherapy-induced nausea and vomiting (CINV) in highly emetogenic chemotherapy (HEC) and has recently been introduced to oncology practice in Japan. However, whether all patients undergoing HEC truly need NK-1 receptor antagonist remains unknown, and increasing medical costs due to uniform use of NK-1 receptor antagonist are a concern. This study was conducted to examine the prevalence of patients who needed aprepitant at the time of its introduction in Japan, and therapeutic and preventive effects of aprepitant on HEC or moderately emetogenic chemotherapy (MEC). PATIENTS AND METHODS Eligible patients with thoracic malignancies who were to undergo HEC or MEC received 5-hydroxytryptamine receptor antagonists and dexamethasone to prevent CINV. Aprepitant was administered to treat CINV occurring in the first course, or to prevent CINV in the second course. Frequency of vomiting, degree of nausea, and quality of life with respect to CINV were assessed. RESULTS In total, 96 patients were enrolled. Aprepitant was not administered in 57 and 88 % of patients who received HEC and MEC, respectively. In patients treated with aprepitant (n = 18), therapeutic use of aprepitant after occurrence of CINV (n = 9) decreased average scores in numerical rating scale for nausea from 7.44 to 5.44 (p = 0.10), and average frequency of vomiting per day from 2.11 to 0.11 (p = 0.03). Prophylactic use of aprepitant in the second course (n = 18) increased the proportion of patients with no significant nausea from 6 % (first course) to 50 % (second course; p = 0.007), and those with no vomiting from 33 to 89 % (p = 0.002). Aprepitant use also significantly improved quality of life with respect to CINV in the second course. CONCLUSION More than half of patients receiving HEC and 88 % of patients receiving MEC did not use aprepitant. Aprepitant showed significant therapeutic and preventive effects on CINV in patients who truly needed it.
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Affiliation(s)
- Sumiyo Ito
- Department of Pharmacy, Aichi Medical University Hospital, Aichi, Japan
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Kim HK, Hsieh R, Chan A, Yu S, Han B, Gao Y, Baños A, Ying X, Burke TA, Keefe DMK. Impact of CINV in earlier cycles on CINV and chemotherapy regimen modification in subsequent cycles in Asia Pacific clinical practice. Support Care Cancer 2014; 23:293-300. [PMID: 25142702 DOI: 10.1007/s00520-014-2376-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 07/29/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE We sought to describe the impact of chemotherapy-induced nausea and vomiting (CINV) in prior cycles on CINV and chemotherapy regimen modification in subsequent cycles. METHODS Eligible patients in this multinational prospective observational study were adults (≥18 years old) receiving their first single-day highly or moderately emetogenic chemotherapy (HEC or MEC). Multivariate logistic regression was used to assess the impact of CINV in prior cycles on CINV in subsequent cycles. Other independent variables included in the model were the cycle number, age, sex, and emetogenicity of regimen. RESULTS There were 598 evaluable patients in cycle 2 and 533 in cycle 3, half receiving HEC and half MEC. Patients who experienced complete response (no emesis or rescue antiemetics) in earlier cycles, relative to those with no complete response, had an adjusted odds ratio (OR) of 5.9 (95% confidence interval (CI), 4.14-8.50) for experiencing complete response in subsequent cycles. Prior CINV was a significant and consistent predictor of subsequent CINV for all CINV endpoints: for emesis, OR 12.7 (95% CI, 8.47-18.9), for clinically significant nausea, OR 7.9 (95% CI, 5.66-10.9), and for clinically significant nausea and/or vomiting, OR 7.2 (5.17-10.1). Modifications to chemotherapy were recorded for 26-29% of patients in cycles 2 and 3, with CINV as the major reason for the modification for 5-9% of these patients. CONCLUSIONS CINV in prior cycles was a strong and consistent predictor of CINV in subsequent cycles, while the incidence of chemotherapy regimen modification due to CINV was low in individual cycles.
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Affiliation(s)
- Hoon-Kyo Kim
- St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
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30
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Assessing the burden and management of chemotherapy induced emesis in the Asia/Pacific region. Support Care Cancer 2014; 23:251-2. [PMID: 25084744 DOI: 10.1007/s00520-014-2371-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 07/24/2014] [Indexed: 12/11/2022]
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31
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Molassiotis A, Aapro M, Dicato M, Gascon P, Novoa SA, Isambert N, Burke TA, Gu A, Roila F. Evaluation of risk factors predicting chemotherapy-related nausea and vomiting: results from a European prospective observational study. J Pain Symptom Manage 2014; 47:839-848.e4. [PMID: 24075401 DOI: 10.1016/j.jpainsymman.2013.06.012] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 06/09/2013] [Accepted: 06/16/2013] [Indexed: 10/26/2022]
Abstract
CONTEXT Demographic, personal, clinical, and behavioral factors predicting chemotherapy-induced nausea and vomiting (CINV) have been assessed in the past, but inconsistencies exist in the literature, studies have methodological shortcomings, and many risk factors have been examined in cross-sectional studies and univariate analyses. OBJECTIVES To evaluate the predictive power of personal and treatment-related characteristics in the development of CINV, using a large and prospectively evaluated sample of a heterogeneous group of cancer patients receiving routine chemotherapy. METHODS This was a multicountry, multisite prospective study over three cycles of chemotherapy. Adult patients from eight European countries about to receive highly and moderately emetogenic chemotherapy were recruited. Clinicians completed a case report form at or before the initial chemotherapy treatment, recording patient demographic and baseline clinical characteristics. Participants completed a daily patient diary for six days per chemotherapy cycle describing their CINV experience. Baseline patient data also included a history of nausea/vomiting (yes/no), patient expectation of nausea (0-100 mm visual analogue scale [VAS]), prechemotherapy anxiety (0-100 mm VAS), and prechemotherapy nausea (0-100 mm VAS) measured during the 24-hour period before chemotherapy initiation. RESULTS There were 991 evaluable patients with complete Cycle 1 data, 888 for Cycle 2 data, and 769 for Cycle 3 data. A complex picture of predictor variables was shown, with different contribution of variables to the acute, delayed, and overall phases of CINV. Key predictor variables included the use of antiemetics inconsistent with international guidelines, younger age, prechemotherapy nausea, and no CINV complete response in an earlier cycle (all at P < 0.05). Anxiety, history of nausea/vomiting, and expectations of nausea were important predictors for some phases and cycles but not consistently across the CINV pathway. CONCLUSION The results of this study provide clarity for the relative contribution of a set of characteristics in the development of CINV. Following evidence-based clinical antiemetic guidelines is of paramount importance, alongside treating patients with increased risk for CINV more aggressively, which both could lead to more optimal CINV management. These data can assist clinicians in making decisions about the antiemetic management of their patients.
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Affiliation(s)
| | - Matti Aapro
- Medical Oncology and Radiation, IMO Clinique de Genolier, Genolier, Switzerland
| | - Mario Dicato
- Hematology-Oncology, Luxembourg Medical Center, Luxembourg, Luxembourg
| | - Pere Gascon
- Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Sylvia A Novoa
- Hospital Teresa Herrera-Complejo Hospitalario Universitario A Coruña-CHUAC, A Coruña, Spain
| | | | - Thomas A Burke
- Global Health Outcomes, Merck Sharp & Dohme Corp., Whitehouse Station, New Jersey, USA
| | - Anna Gu
- St. John's University, New York, New York, USA
| | - Fausto Roila
- Medical Oncology, Santa Maria Hospital, Terni, Italy
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32
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Anticipatory nausea and vomiting due to chemotherapy. Eur J Pharmacol 2013; 722:172-9. [PMID: 24157982 DOI: 10.1016/j.ejphar.2013.09.071] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 09/04/2013] [Accepted: 09/22/2013] [Indexed: 01/17/2023]
Abstract
As a specific variation of chemotherapy-induced nausea and vomiting, anticipatory nausea and vomiting (ANV) appears particularly linked to psychological processes. The three predominant factors related to ANV are classical conditioning; demographic and treatment-related factors; and anxiety or negative expectancies. Laboratory models have provided some support for these underlying mechanisms for ANV. ANV may be treated with medical or pharmacological interventions, including benzodiazepines and other psychotropic medications. However, behavioral treatments, including systematic desensitization, remain first line options for addressing ANV. Some complementary treatment approaches have shown promise in reducing ANV symptoms. Additional research into these approaches is needed. This review will address the underlying models of ANV and provide a discussion of these various treatment options.
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Warr D. Prognostic factors for chemotherapy induced nausea and vomiting. Eur J Pharmacol 2013; 722:192-6. [PMID: 24157977 DOI: 10.1016/j.ejphar.2013.10.015] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 10/04/2013] [Accepted: 10/08/2013] [Indexed: 01/17/2023]
Abstract
PURPOSE to review the topic of prognostic factors for chemotherapy-induced nausea and vomiting. Multiple patient factors such as age, gender and alcohol intake have been found that affect the likelihood of emesis with a given chemotherapy. Pharmacogenomics has also been explored as a cause for variation in emetic response. In theory these risk factors could be used to optimize antiemetic therapy for individual patients but guidelines for prophylactic antiemetics are based solely upon the type of chemotherapy administered. Attempts to identify subgroups of patients for whom guidelines recommendations are suboptimal have thus far been unsuccessful except for those with a poor experience in a previous cycle of the same chemotherapy. At present, there is no basis for deviating from evidence-based guidelines when prescribing antiemetics prior to the first cycle of chemotherapy.
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Affiliation(s)
- David Warr
- Department of Hematology and Medical Oncology, Princess Margaret Cancer Centre, Rm 5-204, 610 University Avenue, Toronto, Ontario, Canada.
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34
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Colagiuri B, Dhillon H, Butow PN, Jansen J, Cox K, Jacquet J. Does assessing patients' expectancies about chemotherapy side effects influence their occurrence? J Pain Symptom Manage 2013; 46:275-81. [PMID: 23149081 DOI: 10.1016/j.jpainsymman.2012.07.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 08/01/2012] [Indexed: 11/15/2022]
Abstract
CONTEXT Increasing evidence suggests a link between patients' expectancies and post-chemotherapy side effects. However, it remains unclear whether asking patients about their expectancies might actually increase side effects. OBJECTIVES The present study tested whether questioning first-time chemotherapy patients about their pretreatment expectancies for four common side effects influences the occurrence and/or severity of these side effects post-treatment and whether these pretreatment expectancies are predictive of post-treatment side effects. METHODS Ninety-one first-time chemotherapy patients were randomly allocated to have their expectancies for nausea, fatigue, feelings of sadness, and loss of appetite assessed before their first infusion or to no such assessment. All patients then rated the occurrence and severity of these side effects at the end of their first chemotherapy cycle. RESULTS There were no statistically significant differences in occurrence or severity of side effects in those who had their expectancies assessed compared with those who did not. There was, however, evidence of a statistically significant positive relationship between patients' pretreatment expectancies and their post-treatment reports of nausea, loss of appetite, and feelings of sadness, after controlling for age, sex, and baseline symptom levels. CONCLUSION These findings suggest that patient expectancies might be a useful point of intervention for attempting to reduce the burden of chemotherapy-related side effects, as there do not appear to be any detrimental effects of asking patients to report their expectancies and their expectancies do appear related to the occurrence of post-treatment side effects.
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Affiliation(s)
- Ben Colagiuri
- School of Psychology, Centre for Medical Psychology, Sydney School of Public Health, University of Sydney, Sydney, NSW 2052, Australia.
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35
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Molassiotis A, Stamataki Z, Kontopantelis E. Development and preliminary validation of a risk prediction model for chemotherapy-related nausea and vomiting. Support Care Cancer 2013; 21:2759-67. [PMID: 23715816 DOI: 10.1007/s00520-013-1843-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 05/07/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND A number of risk factors have been implicated in the development of chemotherapy-induced nausea/vomiting (CINV). Our aim was to develop a risk prediction model and identify patients at high risk for developing CINV before their chemotherapy treatment. PATIENTS AND METHODS A multisite, observational, prospective longitudinal design was used. Participants were 336 chemotherapy-naïve cancer patients providing 791 assessments. They completed measures to assess potential risk factors for CINV, including socio-demographic and clinical/treatment-related characteristics, symptom distress, expectations for CINV and state-trait anxiety. CINV was measured with the MASCC Antiemesis Tool. Participants were divided randomly to a training set (=286) and a test set (=50). Random-effects models were run to ascertain the contribution of risk factors in the development of CINV using the training sample. Specificity and sensitivity of the model were assessed in both sets of samples. RESULTS Younger age, history of nausea/vomiting, trait anxiety and fatigue were linked with higher levels of CINV, and use of moderately and low emetogenic chemotherapy were linked with lower CINV. The model's specificity were 55.4 and 50.0 % and sensitivity were 80.3 and 79.0 % in the training and test sample, respectively. A dynamic web-based tool is freely available for use by clinicians. CONCLUSION This model of risk prediction for CINV can be an aid to clinical decision-making and assist clinicians to rationalise antiemetic use with their patients.
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Affiliation(s)
- A Molassiotis
- School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK,
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36
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Abstract
Nausea and vomiting remain among the most feared side effects of chemotherapy for cancer patients. Significant progress has been made in the last 15 years in developing more effective and better-tolerated measures to minimize chemotherapy-induced nausea and vomiting (CINV). During the 1990s, the selective 5-hydroxytryptamine receptor antagonists were first introduced for the treatment of CINV, and resulted in more effective and better tolerated treatment of CINV. Despite recent progress, however, a significant number of patients still develop CINV, particularly during the 2-5-day period (delayed emesis) following chemotherapy. There is evidence that this may be an underappreciated problem on the part of some caregivers. Recently, two new antiemetics, aprepitant, the first member of the neurokinin-1 antagonists, and palonosetron, a second-generation 5-hydroxytryptamine receptor antagonist, received regulatory approval in the U.S. Both represent useful additions to the therapeutic armamentarium for the management of CINV.
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Affiliation(s)
- Prasan R Bhandari
- Department of Pharmacology, S.D.M.College of Medical Sciences and Hospital, Sattur, Dharwad, Karnataka, India
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37
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Pérol D, Provençal J, Hardy-Bessard AC, Coeffic D, Jacquin JP, Agostini C, Bachelot T, Guastalla JP, Pivot X, Martin JP, Bajard A, Ray-Coquard I. Can treatment with Cocculine improve the control of chemotherapy-induced emesis in early breast cancer patients? A randomized, multi-centered, double-blind, placebo-controlled Phase III trial. BMC Cancer 2012; 12:603. [PMID: 23244208 PMCID: PMC3582626 DOI: 10.1186/1471-2407-12-603] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 12/05/2012] [Indexed: 03/03/2023] Open
Abstract
Background Chemotherapy induced nausea and vomiting (CINV) remains a major problem that seriously impairs the quality of life (QoL) in cancer patients receiving chemotherapy regimens. Complementary medicines, including homeopathy, are used by many patients with cancer, usually alongside with conventional treatment. A randomized, placebo-controlled Phase III study was conducted to evaluate the efficacy of a complex homeopathic medicine, Cocculine, in the control of CINV in non-metastatic breast cancer patients treated by standard chemotherapy regimens. Methods Chemotherapy-naïve patients with non-metastatic breast cancer scheduled to receive 6 cycles of chemotherapy including at least three initial cycles of FAC 50, FEC 100 or TAC were randomized to receive standard anti-emetic treatment plus either a complex homeopathic remedy (Cocculine, registered in France for treatment of nausea and travel sickness) or the matching placebo (NCT00409071 clinicaltrials.gov). The primary endpoint was nausea score measured after the 1st chemotherapy course using the FLIE questionnaire (Functional Living Index for Emesis) with 5-day recall. Secondary endpoints were: vomiting measured by the FLIE score, nausea and vomiting measured by patient self-evaluation (EVA) and investigator recording (NCI-CTC AE V3.0) and treatment compliance. Results From September 2005 to January 2008, 431 patients were randomized: 214 to Cocculine (C) and 217 to placebo (P). Patient characteristics were well-balanced between the 2 arms. Overall, compliance to study treatments was excellent and similar between the 2 arms. A total of 205 patients (50.9%; 103 patients in the placebo and 102 in the homeopathy arms) had nausea FLIE scores > 6 indicative of no impact of nausea on quality of life during the 1st chemotherapy course. There was no difference between the 2 arms when primary endpoint analysis was performed by chemotherapy stratum; or in the subgroup of patients with susceptibility to nausea and vomiting before inclusion. In addition, nausea, vomiting and global emesis FLIE scores were not statistically different at any time between the two study arms. The frequencies of severe (Grade ≥ 2) nausea and vomiting were low in our study (nausea: P: 17.6% vs C: 15.7%, p=0.62; vomiting: P: 10.8% vs C: 12.0%, p=0.72 during the first course). Conclusion This double-blinded, placebo-controlled, randomised Phase III study showed that adding a complex homeopathic medicine (Cocculine) to standard anti-emetic prophylaxis does not improve the control of CINV in early breast cancer patients.
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Affiliation(s)
- David Pérol
- Centre Léon Bérard, 28 rue Laennec, Lyon Cedex 08, 69373, France
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Younger J, Gandhi V, Hubbard E, Mackey S. Development of the Stanford Expectations of Treatment Scale (SETS): A tool for measuring patient outcome expectancy in clinical trials. Clin Trials 2012; 9:767-76. [DOI: 10.1177/1740774512465064] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background A patient’s response to treatment may be influenced by the expectations that the patient has before initiating treatment. In the context of clinical trials, the influence of participant expectancy may blur the distinction between real and sham treatments, reducing statistical power to detect specific treatment effects. There is therefore a need for a tool that prospectively predicts expectancy effects on treatment outcomes across a wide range of treatment modalities. Purpose To help assess expectancy effects, we created the Stanford Expectations of Treatment Scale (SETS): an instrument for measuring positive and negative treatment expectancies. Internal reliability of the instrument was tested in Study 1. Criterion validity of the instrument (convergent, discriminant, and predictive) was assessed in Studies 2 and 3. Methods The instrument was developed using 200 participants in Study 1. Reliability and validity assessments were made with an additional 423 participants in Studies 2 and 3. Results The final six-item SETS contains two subscales: positive expectancy (α = 0.81–0.88) and negative expectancy (α = 0.81–0.86). The subscales predict a significant amount of outcome variance (between 12% and 18%) in patients receiving surgical and pain interventions. The SETS is simple to administer, score, and interpret. Conclusion The SETS may be used in clinical trials to improve statistical sensitivity for detecting treatment differences or in clinical settings to identify patients with poor treatment expectancies.
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Affiliation(s)
- Jarred Younger
- Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - Vanisha Gandhi
- Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - Emily Hubbard
- Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - Sean Mackey
- Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
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Wickham R. Evolving treatment paradigms for chemotherapy-induced nausea and vomiting. Cancer Control 2012; 19:3-9. [PMID: 22488022 DOI: 10.1177/107327481201902s02] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Chemotherapy-induced nausea and vomiting (CINV) is one of the most debilitating toxicities associated with cancer treatment. Although effective antiemetic agents are available, their use in practice often is suboptimal. METHODS The author reviews the pathophysiology of CINV as well as the drug classes and cost considerations that should be incorporated into treatment planning. RESULTS Several drug classes, including 5-hydroxytryptamine-3 receptor antagonists, neurokinin-1 receptor antagonists, and corticosteroids, are effective, especially when used in combination. Older antiemetic agents, such as prochlorperazine and metoclopramide, as well as olanzapine may provide reasonable alternatives in certain settings. CONCLUSIONS Interventions for CINV should include standard-of-care antiemetics combined with corticosteroids. The cost of using older, less expensive antiemetics may be outweighed by the expenditures to rescue patients after suboptimal prophylaxis, as well as the indirect costs of missed work and lost productivity.
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Affiliation(s)
- Rita Wickham
- Northern Michigan University School of Nursing, Marquette, Michigan 49855, USA.
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Scialdone L. Overview of supportive care in patients receiving chemotherapy: antiemetics, pain management, anemia, and neutropenia. J Pharm Pract 2012; 25:209-221. [PMID: 22307093 DOI: 10.1177/0897190011431631] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
With advancements in the field of oncology, more and more people are living with cancer. The prevalence of invasive cancer in the United States is estimated to be almost 12 million. The treatment of cancer as well as the malignancy itself can cause an immense number of side effects and other complications. This article explores the fundamentals of supportive care in patients receiving chemotherapy and radiation treatment including prevention of nausea and vomiting, pain management, treatment of anemia and neutropenia. Proper supportive care can help improve clinical outcomes, reduce medical costs, and help patients with cancer live longer, happier, and healthier lives. For these reasons, it is important for pharmacists to possess a solid understanding of how to prevent and treat the adverse effects of chemotherapy and radiation treatment.
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Affiliation(s)
- Liana Scialdone
- Albany College of Pharmacy and Health Sciences, Albany, NY 12208, USA.
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[Comparative study of the efficacy and safety of two anti-emetic protocols in gynecological chemotherapy]. FARMACIA HOSPITALARIA 2012; 36:220-8. [PMID: 22119166 DOI: 10.1016/j.farma.2011.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 05/30/2011] [Accepted: 06/23/2011] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the efficacy and safety of an update to an anti-emetic protocol in chemotherapy for gynecological tumours. METHOD Prospective observational study performed over 12 months in a general hospital with 400 beds. We evaluated the efficacy of the old anti-emetic protocol, a new protocol was implemented, and its efficacy was determined. We included patients with gynaecological tumours that sought treatment at the Day Hospital. After each chemotherapy cycle, patients filled out a survey that registered the number and severity of episodes of nausea/vomiting and other adverse effects. The efficacy of treatment was measured as complete response (no nausea or vomit) in the acute phase (first 24h after chemotherapy) and late phase (2-5 days after chemotherapy). We also evaluated whether age, the type of protocol, and the emetogenous power of the different treatment schemes could influence patient response. RESULTS We analysed 102 chemotherapy cycles under the old protocol (52 patients) and 293 cycles under the new protocol (98 patients). We observed significant differences in complete response rates in the late phase between old and new protocols (36.27% vs 67.38%, P<.0001). The probability of obtaining a complete response using the new protocol was twice as high as with the old protocol in acute emesis (OR=1.85, 95% CI: 1.05-3.24, P=.03) and four times higher in late emesis (OR=4.27, 95% CI: 2.59-7.02, P<.0001). CONCLUSIONS A greater percentage of complete responses to late emesis was obtained using the new protocol. Age and the low emetogenous power of the treatment schemes were predictive factors for complete response in acute emesis.
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Mir O, Durand JP, Boudou-Rouquette P, Giroux J, Coriat R, Cessot A, Ropert S, Goldwasser F, Gaillard R. Interaction between serotonin reuptake inhibitors, 5-HT3 antagonists, and NK1 antagonists in cancer patients receiving highly emetogenic chemotherapy: a case-control study. Support Care Cancer 2012; 20:2235-9. [PMID: 22644261 DOI: 10.1007/s00520-012-1503-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 05/20/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND Previous reports suggested that selective serotonin reuptake inhibitors (SSRI) could decrease the activity of 5-hydroxytryptamine type 3 (5-HT3) antagonists against acute chemotherapy-induced nausea and vomiting (CINV), possibly through serotonin accumulation for 5-HT3 receptors. PATIENTS AND METHODS Chemonaive cancer patients receiving SSRI and antiemetic agents, including the 5-HT3 antagonist ondansetron and the neurokinin 1 (NK1) antagonist aprepitant for highly emetogenic chemotherapy (etoposide-platinum), were matched to control patients for the following variables: age, gender, primary tumor, past history of gestational emesis, chronic intake of benzodiazepines and/or corticosteroids, chronic alcohol intake, and aprepitant use. The primary evaluation criterion was the occurrence of acute vomiting during the first two cycles of treatment. RESULTS Forty-four patients were eligible for this analysis. The proportion of patients, who experienced at least one episode of grade ≥ 1 acute vomiting in patients receiving SSRI, compared to patients who did not, was significantly higher (59.1 vs. 22.7%, respectively, p = 0.03, odds ratio 4.72, 95% confidence interval 1.13-22.88). Grade ≥ 2 acute vomiting was also significantly more frequent in patients receiving SSRI, even after the implementation of aprepitant to antiemetic prophylaxis (41.2 vs. 5.9%, p = 0.04). CONCLUSIONS Our findings reinforce the hypothesis that SSRI decrease the antiemetic activity of the 5-HT3 serotonin antagonist ondansetron, resulting in higher rates of acute vomiting in cancer patients despite adequate antiemetic prophylaxis. Adding the NK1 antagonist aprepitant do not counterbalance the deleterious effect of SSRI, probably due to the synergistic effects of SSRI and NK1 antagonists on serotonin transmission.
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Affiliation(s)
- Olivier Mir
- Department of Medical Oncology, Cochin Teaching Hospital, Université Paris Descartes, Sorbonne Paris Cité, AP-HP, Paris, France.
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Schwartzberg L, Szabo S, Gilmore J, Haislip S, Jackson J, Jain G, Balu S, Buchner D. Likelihood of a subsequent chemotherapy-induced nausea and vomiting (CINV) event in patients receiving low, moderately or highly emetogenic chemotherapy (LEC/MEC/HEC). Curr Med Res Opin 2011; 27:837-45. [PMID: 21309647 DOI: 10.1185/03007995.2011.556603] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the likelihood of subsequent chemotherapy-induced nausea and vomiting (CINV) events following a first chemotherapy administration CINV event in patients receiving single-day low, moderately, or highly emetogenic chemotherapy (LEC, MEC, or HEC). METHODS A retrospective analysis was conducted utilizing Georgia Cancer Specialists, Florida Cancer Specialists, and ACORN electronic medical records databases (April 2006 through July 2009). Patients were included who received more than one single-day LEC, MEC, or HEC administration (oral or intravenous) with no chemotherapy 3 months prior to the first LEC, MEC, or HEC administration. Two cohorts, patients with a first administration CINV and no first administration CINV, were created and followed for 6 months. A multivariate logistic regression assessed the likelihood of subsequent CINV, controlling for age, gender, Charlson comorbidity index, cancer type, number of chemotherapy administrations, gap between LEC, MEC, or HEC administrations, and number of different LEC, MEC, or HEC agents administered. RESULTS A total of 10,586 patients met the inclusion criteria (LEC = 3099; MEC = 5172; HEC = 2315). Of those patients, 4.4% (n = 136), 7.8% (n = 402), and 13.8% (n = 320) experienced a CINV event with their initial single-day LEC, MEC, or HEC administration, respectively. The unadjusted subsequent CINV rate was higher in the cohorts with first LEC, MEC, or HEC administration CINV for all groups receiving LEC (33.1% vs. 16.0%; p < 0.0001), MEC (46.5% vs. 18.9%; p < 0.0001), or HEC (59.1% vs. 26.9%; p < 0.0001). After controlling for covariates, patients with first LEC, MEC, or HEC administration CINV were 3.1, 3.8, and 3.7 times more likely to have a subsequent CINV compared to patients without a first LEC, MEC, or HEC administration CINV (Odds Ratio: 3.05 [95% CI: 2.08-4.48, p < 0.0001]; 3.77 [95% CI: 3.04-4.68, p < 0.0001]; and 3.70 [95% CI: 2.88-4.74, p < 0.0001], respectively). CONCLUSION In this retrospective analysis, patients receiving single-day LEC, MEC, or HEC who had a prior CINV were at increased risk of subsequent CINV. Further studies assessing increased risk of a subsequent CINV events are warranted given this study represents an assessment of electronic medical record data within select community-based populations under usual care.
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Affiliation(s)
- Lee Schwartzberg
- Accelerated Community Oncology Research Network, Memphis, TN, USA
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Colagiuri B, Zachariae R. Patient expectancy and post-chemotherapy nausea: a meta-analysis. Ann Behav Med 2011; 40:3-14. [PMID: 20387022 DOI: 10.1007/s12160-010-9186-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Post-chemotherapy nausea remains a significant burden to cancer patients. While some studies indicate that expecting nausea is predictive of experiencing nausea, there are a number of conflicting findings. PURPOSE The purpose of this study was to conduct a meta-analytic review to determine the strength of the relationship between expectancy and post-chemotherapy nausea. METHODS The findings from 17 relevant studies (n = 2,400) identified through systematic searches of Medline, PsycInfo, and Cinhal were analyzed using a combination of meta-analytic techniques. RESULTS Overall, there was a robust positive association between expectancy and post-chemotherapy nausea (ESr = 0.18, equivalent to Cohen's d = 0.35), suggesting that patients with stronger expectancies experience more chemotherapy-induced nausea. Although weaker associations were found in studies employing multivariate analysis, specifically controlling for a history of nausea, and involving breast cancer patients, none of the moderators assessed were statistically significant. CONCLUSIONS These findings suggest that patient expectancies may contribute to post-chemotherapy nausea and that expectancy-based manipulations may provide a useful intervention strategy.
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Affiliation(s)
- Ben Colagiuri
- School of Psychology, A18, University of Sydney, Sydney, NSW, 2006, Australia.
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Nausea and Vomiting. Palliat Care 2011. [DOI: 10.1016/b978-1-4377-1619-1.00008-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Mustian KM, Devine K, Ryan JL, Janelsins MC, Sprod LK, Peppone LJ, Candelario GD, Mohile SG, Morrow GR. Treatment of Nausea and Vomiting During Chemotherapy. US ONCOLOGY & HEMATOLOGY 2011; 7:91-97. [PMID: 24466408 PMCID: PMC3898599 DOI: 10.17925/ohr.2011.07.2.91] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Nausea and vomiting are two of the most troubling side effects patients experience during chemotherapy. While newly available treatments have improved our ability to manage nausea and vomiting, anticipatory and delayed nausea and vomiting are still a major problem for patients receiving chemotherapy. Many cancer patients will delay or refuse future chemotherapy treatments and contemplate stopping chemotherapy altogether because of their fear of experiencing further nausea and vomiting. The purpose of this article is to provide an overview of the patho-psychophysiology of chemotherapy-induced nausea and vomiting and the recommended guidelines for treatment.
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Affiliation(s)
- Karen M Mustian
- James P Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry
| | - Katie Devine
- James P Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry
| | - Julie L Ryan
- James P Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry
| | - Michelle C Janelsins
- James P Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry
| | - Lisa K Sprod
- James P Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry
| | - Luke J Peppone
- James P Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry
| | - Grace D Candelario
- James P Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry
| | - Supriya G Mohile
- James P Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry
| | - Gary R Morrow
- James P Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry
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Roscoe JA, O'Neill M, Jean-Pierre P, Heckler CE, Kaptchuk TJ, Bushunow P, Shayne M, Huston A, Qazi R, Smith B. An exploratory study on the effects of an expectancy manipulation on chemotherapy-related nausea. J Pain Symptom Manage 2010; 40:379-90. [PMID: 20579837 PMCID: PMC3156553 DOI: 10.1016/j.jpainsymman.2009.12.024] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 12/17/2009] [Accepted: 01/19/2010] [Indexed: 10/19/2022]
Abstract
CONTEXT Previous research has shown that the effectiveness of acupressure bands in reducing chemotherapy-related nausea is related to patients' expectations of efficacy. OBJECTIVE To test whether an informational manipulation designed to increase expectation of efficacy regarding acupressure bands would enhance their effectiveness. METHODS We conducted an exploratory, four-arm, randomized clinical trial in breast cancer patients about to begin chemotherapy. All patients received acupressure bands and a relaxation CD. This report focuses on Arm 1(expectancy-neutral informational handout and CD) compared with Arm 4 (expectancy-enhancing handout and CD). Randomization was stratified according to the patient's level of certainty that she would have treatment-induced nausea (two levels: high and low). Experience of nausea and use of antiemetics were assessed with a five-day diary. RESULTS Our expectancy-enhancing manipulation resulted in improved control of nausea in the 26 patients with high nausea expectancies but lessened control of nausea in 27 patients having low nausea expectancies. This interaction effect (between expected nausea and intervention effectiveness) approached statistical significance for our analysis of average nausea (P=0.084) and reached statistical significance for our analysis of peak nausea (P=0.030). Patients receiving the expectancy-enhancing manipulation took fewer antiemetic pills outside the clinic (mean(enhanced)=12.6; mean(neutral)=18.5, P=0.003). CONCLUSION This exploratory intervention reduced antiemetic use overall and also reduced nausea in patients who had high levels of expected nausea. Interestingly, it increased nausea in patients who had low expectancies for nausea. Confirmatory research is warranted.
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Affiliation(s)
- Joseph A Roscoe
- University of Rochester James P. Wilmot Cancer Center, Rochester, New York 14642, USA.
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Kenten C, Bowling A, Lambert N, Howe A, Rowe G. A study of patient expectations in a Norfolk general practice. Health Expect 2010; 13:273-84. [PMID: 20550590 DOI: 10.1111/j.1369-7625.2010.00603.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To use semi-structured interviews to ascertain patterns in patients' expectations of health care and the extent to which these expectations were met or not. BACKGROUND In health policy it is important to evaluate health services from varying perspectives including consumers'. One concept of emerging importance in this regard is that of patient expectations. Whether expectations are met or not have been found to be related to general patient satisfaction with treatment and treatment compliance. However, there is conceptual and methodological uncertainty and little informing empirical work regarding what is an 'expectation' and how it should be measured. DESIGN A qualitative study using semi-structured interviews to elicit 20 GP patients' expectations prior to their consultation. A post consultation interview gauged the extent to which these expectations had been met. SETTING AND PARTICIPANT: Twenty patients of a GP practice in Norfolk (UK). RESULTS Results suggest several different expectations, concerned with the doctor-patient interaction, the specific processes of the consultation, outcomes, and issues to do with time and space. CONCLUSIONS This research has used an innovative exploratory approach to address the expectations of GP patients and has implications for how doctors ought to manage their consultations. These results will be used to inform the development of a quantitative expectations questionnaire so as to develop a validated measure of expectations. Such an instrument has great potential to aid in health care research and practice.
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Affiliation(s)
- Charlotte Kenten
- Division of Health and Social Care Research, King's College London, London, UK.
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Abstract
For over 30 years, chemotherapy-induced nausea and vomiting have been the most severe and troublesome symptoms for cancer patients receiving chemotherapy. Unresolved chemotherapy-induced nausea and vomiting can lead to metabolic disorders, dehydration, nutritional depletion and esophageal tears, and can reduce patients' daily functioning and quality of life and interfere with treatment schedules.(1, 2) Despite the widespread use of antiemetics, chemotherapy-induced nausea continues to be problematic. Unlike vomiting, nausea is a subjective and unobservable phenomenon making it extremely difficult to accurately assess and treat. Current research suggests that management of chemotherapy-induced nausea should focus on treating the symptoms before they occur rather than after they develop. This review highlights evidence-based interventions for the treatment of chemotherapy-related nausea.
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Affiliation(s)
- Julie L Ryan
- Departments of Dermatology and Radiation Oncology, University of Rochester Medical Center and James P. Wilmot Cancer Center, Rochester, NY
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Sohl SJ, Schnur JB, Montgomery GH. A meta-analysis of the relationship between response expectancies and cancer treatment-related side effects. J Pain Symptom Manage 2009; 38:775-84. [PMID: 19775863 PMCID: PMC2783563 DOI: 10.1016/j.jpainsymman.2009.01.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Revised: 01/13/2009] [Accepted: 02/19/2009] [Indexed: 01/30/2023]
Abstract
Response expectancies, defined as expectations for nonvolitional responses, have been proposed to contribute to the experience of side effects of cancer and its treatment. To statistically evaluate this association, a systematic search of the published literature was conducted, resulting in 14 studies appropriate for meta-analysis. Results revealed a significant (Z=6.58, P<0.001) medium-sized (r=0.36) association between patients' response expectancies for cancer treatment-related side effects and the experience of these side effects. Assessment of response expectancies with reference to the time the treatment-related side effect would occur resulted in larger effect sizes than when such temporal specificity in assessment was not included, Q(1)=10.27, P<0.01. Effect sizes were also moderated by patients' prior experience with cancer treatment, Q(1)=18.91, P=0.001, such that prior experience led to stronger associations between response expectancies and side effects than no prior experience. Relationships between response expectancies and pain, fatigue, nausea, and vomiting were explored. Effect sizes did not differ between side effects, with the exception that the relationship was significantly stronger for pain than for vomiting (P<0.05). Overall, these results support the contribution of response expectancies to cancer treatment-related side effects. Additionally, the results support the conduct of research on interventions to alter response expectancies, with the goal of reducing side effects and improving patient quality of life.
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Affiliation(s)
- Stephanie J Sohl
- Department of Oncological Sciences, Mount Sinai School of Medicine, New York, New York 10029-6574, USA.
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