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Sommariva S, Pongiglione B, Tarricone R. Impact of chemotherapy-induced nausea and vomiting on health-related quality of life and resource utilization: A systematic review. Crit Rev Oncol Hematol 2016; 99:13-36. [DOI: 10.1016/j.critrevonc.2015.12.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 10/01/2015] [Accepted: 12/01/2015] [Indexed: 11/25/2022] Open
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Keat CH, Ghani NA. Cost-effectiveness analysis of granisetron-based versus standard antiemetic regimens in low-emetogenic chemotherapy: a hospital-based perspective from Malaysia. Asian Pac J Cancer Prev 2014; 14:7701-6. [PMID: 24460356 DOI: 10.7314/apjcp.2013.14.12.7701] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In a prospective cohort study of antiemetic therapy conducted in Malaysia, a total of 94 patients received low emetogenic chemotherapy (LEC) with or without granisetron injections as the primary prophylaxis for chemotherapy-induced nausea and vomiting (CINV). This study is a retrospective cost analysis of two antiemetic regimens from the payer perspective. MATERIALS AND METHODS This cost evaluation refers to 2011, the year in which the observation was conducted. Direct costs incurred by hospitals including the drug acquisition, materials and time spent for clinical activities from prescribing to dispensing of home medications were evaluated (MYR 1=$0.32 USD). As reported to be significantly different between two regimens (96.1% vs 81.0%; p=0.017), the complete response rate of acute emesis which was defined as a patient successfully treated without any emesis episode within 24 hours after LEC was used as the main indicator for effectiveness. RESULTS Antiemetic drug acquisition cost per patient was 40.7 times higher for the granisetron-based regimen than for the standard regimen (MYR 64.3 vs 1.58). When both the costs for materials and clinical activities were included, the total cost per patient was 8.68 times higher for the granisetron-based regimen (MYR 73.5 vs 8.47). Considering the complete response rates, the mean cost per successfully treated patient in granisetron group was 7.31 times higher (MYR 76.5 vs 10.5). The incremental cost-effectiveness ratio (ICER) with granisetron-based regimen, relative to the standard regimen, was MYR 430.7. It was found to be most sensitive to the change of antiemetic effects of granisetron-based regimen. CONCLUSIONS While providing a better efficacy in acute emesis control, the low incidence of acute emesis and high ICER makes use of granisetron as primary prophylaxis in LEC controversial.
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Affiliation(s)
- Chan Huan Keat
- Department of Pharmacy, Sultanah Bahiyah Hospital, Alor Setar, Kedah, Malaysia E-mail :
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Zeitoun AA, Nassif JG. Evaluation of anti-emetic use in chemotherapy-induced nausea and vomiting in a third-world country (Lebanon). J Eval Clin Pract 2013; 19:68-75. [PMID: 21999252 DOI: 10.1111/j.1365-2753.2011.01770.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
RATIONALE In Lebanon, the appropriateness of anti-emetic use is questionable in large measure because of the absence of published multicentre trials. AIM AND OBJECTIVES To evaluate the extent of appropriateness of anti-emetic use in patients on chemotherapy among several Lebanese hospitals. Appropriateness of chemotherapy-induced nausea and vomiting (CINV) prophylaxis was determined as per National Comprehensive Cancer Network guidelines. METHODS A multicentre, cross-sectional study was conducted over a 3-month period. Data were collected from medical charts of cancer patients. The main outcome measure was to evaluate the appropriateness of prophylactic use of anti-emetics in CINV in terms of selected drug regimen, dosage and route of administration, and to investigate the role of several pre-specified variables (including hospital type and size, type of insurance coverage and patient-related factors) in influencing the appropriateness of anti-emetic practice. RESULTS A total of 493 patients' forms were analysed. The median age was 58.8 ± 13.9 years, 290 (58.8%) patients were female. Around 211 (42.8%) patients received inappropriate anti-emetic regimen, and only 17 (6%) patients of those receiving appropriate regimen received the appropriate dose, and just 55 (19.5%) patients were treated for the appropriate duration. Factors that may affect the relative effectiveness of treatment were identified. CONCLUSION This study reflected substantial flaws in CINV prophylaxis practice in Lebanon which should alert health care professionals of the adverse consequences resulting from non-adherence to guidelines. Our study also highlighted areas for improvement and suggested recommendations in order to minimize patient risk and optimize safe and effective CINV management.
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Affiliation(s)
- Abeer A Zeitoun
- Pharmacy Practice Department, School of Pharmacy, Lebanese American University, Byblos, Lebanon.
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Lachaine J, Yelle L, Kaizer L, Dufour A, Hopkins S, Deuson R. Chemotherapy-induced emesis: quality of life and economic impact in the context of current practice in Canada. ACTA ACUST UNITED AC 2011; 2:181-7. [PMID: 18628170 DOI: 10.3816/sct.2005.n.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In this study, we estimated the proportion of patients who experience chemotherapy-induced nausea and vomiting (CINV) in current practice and evaluated the impact of CINV on quality of life and cost in Canada. Patients receiving highly emetogenic chemotherapy were recruited from 4 Canadian oncology centers. Patients used diaries to record information on their activities, incidence of nausea and vomiting, and health resources consumed each day for 5 days following chemotherapy. They also completed the Functional Living Index-Emesis (FLIE) questionnaire and a health utility instrument before chemotherapy and 5 days later. Of the 323 patients recruited, 266 (82%) completed their diary. On day 1, 26% of patients reported nausea or vomiting (acute emesis). From day 2 to day 5 after chemotherapy, 44% reported nausea or vomiting (delayed emesis). Patients who experienced nausea or vomiting during the study period had a decrease in FLIE score of 22% and a decrease in health utility of 15%. Patients with nausea or vomiting reported an average of 19 hours per cycle during which they were unable to perform their normal activities. Also, friends or relatives spent an average of 10 hours helping these patients. Incremental medical costs per patient experiencing CINV were $61 Canadian. Including productivity losses, total incremental costs were $592 Canadian per patient. Despite use of antiemetics, CINV remains problematic, impacting the quality of life of patients with cancer and increasing costs.
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Affiliation(s)
- Jean Lachaine
- Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada
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Annemans L, Strens D, Lox E, Petit C, Malonne H. Cost-effectiveness analysis of aprepitant in the prevention of chemotherapy-induced nausea and vomiting in Belgium. Support Care Cancer 2007; 16:905-15. [DOI: 10.1007/s00520-007-0349-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Accepted: 10/02/2007] [Indexed: 11/24/2022]
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Dibble SL, Casey K, Nussey B, Israel J, Luce J. Chemotherapy-Induced Vomiting in Women Treated for Breast Cancer. Oncol Nurs Forum 2007; 31:E1-8. [PMID: 14722600 DOI: 10.1188/04.onf.e1-e8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe the incidence and intensity of vomiting in women receiving chemotherapy treatment for breast cancer since the advent of 5-HT3 antagonists. DESIGN Longitudinal, descriptive. SETTING 7 outpatient oncology clinics situated in hospitals, 5 outpatient oncology clinics associated with major teaching universities, 27 private outpatient oncology practices, and 1 outpatient clinic located in a county hospital. SAMPLE Typical participants (N = 303) were 51.9 years, Caucasian (79%), married or partnered (65%), born U.S. citizens (93%), heterosexual (96%), living with someone (84%), and high school graduates (82%). METHODS Baseline and poststudy questionnaires and a daily diary of vomiting through two cycles of chemotherapy (approximately two months) were used to collect data. MAIN RESEARCH VARIABLE Vomiting experience. FINDINGS The worst vomiting occurs three days after having chemotherapy for breast cancer. The types of oral antiemetics ordered for home use were changed between the two cycles of the study only 8% (n = 24) of the time. No demographic factors were associated with acute vomiting at times 1 or 2; younger age (r = -0.16; p = 0.012) was associated with more vomiting. Delayed vomiting was associated with age and body mass index, and younger, heavier women experienced more vomiting. Minority women (n = 55) reported significantly more delayed vomiting than did Caucasian women (mean = 6.56 versus 2.82; t = 2.02; p less than 0.05). CONCLUSIONS Vomiting continues to be a significant problem for some women receiving chemotherapy for breast cancer. IMPLICATIONS FOR NURSING Oncology nurses can use the results from this study to provide anticipatory guidance for patients undergoing chemotherapy for breast cancer and to support efforts to provide appropriate symptom management for these women.
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Affiliation(s)
- Suzanne L Dibble
- Institute for Health and Aging, University of California, San Francisco, CA, USA.
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Lordick F, Ehlken B, Ihbe-Heffinger A, Berger K, Krobot KJ, Pellissier J, Davies G, Deuson R. Health outcomes and cost-effectiveness of aprepitant in outpatients receiving antiemetic prophylaxis for highly emetogenic chemotherapy in Germany. Eur J Cancer 2006; 43:299-307. [PMID: 17134890 DOI: 10.1016/j.ejca.2006.09.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2006] [Revised: 09/22/2006] [Accepted: 09/25/2006] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chemotherapy-induced nausea and vomiting (CINV) remains a major adverse effect of cancer therapy. We aimed to determine outcomes associated with use of aprepitant in outpatients undergoing highly emetogenic chemotherapy in Germany from a patient's and payer's perspective. METHODS A decision-analytic model compared an aprepitant regimen (aprepitant/ondansetron/dexamethasone) to a control regimen (ondansetron/dexamethasone) over a five days period. Clinical results and resource utilisation observed in aprepitant phase III clinical trials were assigned German unit cost data. RESULTS Complete response over one chemotherapy cycle was observed in 68% of patients in the aprepitant group (N=514) compared to 48% of patients in the control group (N=518). Patients were estimated to have gained an equivalent of 15 additional hours of perfect health per cycle (0.63 quality-adjusted life days) with aprepitant-based regimen compared to control regimen. Cost per quality-adjusted life year gained with aprepitant was estimated at euro28,891. CONCLUSIONS Aprepitant substantially improved CINV-related health outcomes in patients undergoing highly emetogenic chemotherapy. Incremental benefits materialised in a cost-effective fashion.
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Affiliation(s)
- Florian Lordick
- Third Medical Department, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany.
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Ballatori E, Roila F, Ruggeri B, Betti M, Sarti S, Soru G, Cruciani G, Di Maio M, Andrea B, Deuson RR. The impact of chemotherapy-induced nausea and vomiting on health-related quality of life. Support Care Cancer 2006; 15:179-85. [PMID: 16941136 DOI: 10.1007/s00520-006-0109-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2006] [Accepted: 06/14/2006] [Indexed: 10/24/2022]
Abstract
GOAL OF WORK The objectives of this prospective observational study were to estimate the frequency of patients who reported an impact of chemotherapy-induced nausea and vomiting (CINV) on their daily life and to evaluate the determinants of such an impact. MATERIALS AND METHODS Adult cancer patients at seven Italian oncology centers who were receiving cisplatin-containing regimens reported incidence and intensity of CINV for eight consecutive days in a diary and completed a Functional Living Index for Emesis (FLIE) questionnaire. MAIN RESULTS Overall, 34% of patients reported vomiting and 62% reported nausea after chemotherapy. On days 1 to 5 after receiving chemotherapy, 67% of patients who had at least one emetic episode and 77% of those who suffered from at least mild nausea experienced an impact on their daily activities as measured on the FLIE questionnaire. More than 90% of all patients with both acute and delayed nausea or vomiting reported an impact on their daily life. Both acute and delayed vomiting contributed in similar measure to impact daily life; however, the importance of delayed nausea was greater than that of acute nausea. CONCLUSIONS Despite antiemetic prophylaxis, CINV is still prevalent and often impacts the daily life of patients in Italy, especially in the delayed phase. The duration more than the severity seems to be responsible for the impact of CINV on the patients' daily lives.
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Affiliation(s)
- Enzo Ballatori
- Medical Statistics Unit, Department of Internal Medicine and Public Health, University of L'Aquila, Via Pillino 2, 63030, Spinetoli (AP), Italy.
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Ballatori E, Roila F, Ruggeri B, Porrozzi S, Iannopollo M, Soru G, Cruciani G, Daniele B, Locatelli MC, Pellissier J, Deuson R. The cost of chemotherapy-induced nausea and vomiting in Italy. Support Care Cancer 2006; 15:31-8. [PMID: 16788840 DOI: 10.1007/s00520-006-0094-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2006] [Accepted: 05/17/2006] [Indexed: 10/24/2022]
Abstract
GOALS OF WORK The aim of this paper is to analyze the costs of chemotherapy-induced nausea and vomiting (CINV) in Italy. MATERIALS AND METHODS In this prospective observational study at seven public oncology centers, incidence and intensity of CINV daily for 8 days after chemotherapy in consecutive patients receiving cisplatin-containing chemotherapy were recorded. All costs related to CINV (direct medical, direct nonmedical, and indirect) were recorded (in 2003 euros). MAIN RESULTS A total of 172 patients were enrolled; cost data were available for 168 patients. Thirty-seven percent of patients experienced acute CINV, and 57% experienced delayed CINV; 39% achieved total control, defined as no nausea, vomiting, or rescue therapy. Mean per-patient costs of acute and delayed CINV were 30.03 euro from the hospital perspective, 4.9 euro from the patient perspective, and 26.85 euro from the National Health Service (NHS) perspective. Costs of CINV were highly variable among oncology centers, largely because of differences in procedures for preventing delayed CINV. These costs were four times higher when antiemetic drugs were prescribed and paid for by the NHS than when antiemetic prophylaxis was provided directly from hospital pharmacies. Moreover, in the delayed phase, the NHS incurred a 94% increase in costs for patients without total control. Overall costs for patients who did not experience total control of CINV were 35.57 euro higher than for those who did (85% increase). CONCLUSIONS Costs of CINV for the Italian NHS could be reduced if hospitals furnished antiemetic prophylaxis directly to patients. Better control of both acute and delayed CINV would improve patient well-being as well as reduce the budgetary impact of CINV in Italy.
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Affiliation(s)
- Enzo Ballatori
- Medical Statistics Unit, Department of Internal Medicine and Public Health, University of L'Aquila, Via Pillino, 2, 63030, Spinetoli (AP), Italy.
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Neymark N, Crott R. Impact of emesis on clinical and economic outcomes of cancer therapy with highly emetogenic chemotherapy regimens: a retrospective analysis of three clinical trials. Support Care Cancer 2005; 13:812-8. [PMID: 15834590 DOI: 10.1007/s00520-005-0803-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2004] [Accepted: 02/23/2005] [Indexed: 01/28/2023]
Abstract
OBJECTIVE It is a current hypothesis that chemotherapy-induced nausea and vomiting (CINV) may ultimately impede the clinical success of cancer treatments by hindering patients' adherence to the optimal treatment schedule. The aim of this study is to examine clinical trial data retrospectively for possible evidence of such a detrimental impact of CINV. PATIENTS AND METHODS Data from three recent European Organization for Research and Treatment of Cancer (EORTC) trials of highly emetogenic cisplatin-based chemotherapy in diverse patient populations were analyzed retrospectively for incidence and possible impact of CINV. Data on the incidence of emesis are presented as simple descriptive analyses, while the hypothetical impact of CINV on clinical outcomes and on the patients' length of hospital stays is analyzed by means of multivariate regression analysis techniques to control for confounding variables. MAIN RESULTS Between 42 and 59% of the patients in the trials experienced at least one episode of nausea of NCIC grade 2 or worse, while the incidence of vomiting of similar grade was between 31 and 58%. Only in one of the trials could the determinants of the adherence to protocol therapy be assessed, statistically significant variables were the severity of emesis (p < 0.0001) and other toxicities combined (p < 0.019). In turn, a Cox regression showed adherence to protocol therapy and other toxicities as the only statistically significant determinants of overall survival. CONCLUSIONS This study has shown a discernible detrimental impact of CINV on patients' adherence to protocol therapy and, indirectly, on survival in one of the three trials examined. Further studies are required to substantiate this finding.
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Tarricone R, Girolami F. Economic Evaluation of a New Antiemetic Drug ??? Palonosetron versus Ondansetron. Clin Drug Investig 2005; 25:597-608. [PMID: 17532704 DOI: 10.2165/00044011-200525090-00005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVES This study aimed to identify, measure and evaluate expected costs of innovative palonosetron-based antiemetic therapy versus ondansetron-based treatment, the ultimate aim being to measure the drug price ratio (DPR) of the two pharmacological treatments in five different European countries. METHODS A decision model compared two antiemetic treatments - palonosetron and ondansetron - in terms of expected costs of emesis management from a hospital perspective. The model was compiled for 374 patients. The clinical superiority of palonosetron in preventing acute and delayed emesis, measured in terms of: (i) complete response rates, (ii) number of emetic episodes, and (iii) administration of rescue medication, was derived from a previously published clinical trial. The cost data were gathered through economic questionnaires distributed in 11 European hospital centres. The expected costs of emesis management with palonosetron and ondansetron at ondansetron prices were used to calculate the DPR for palonosetron in each of the five European countries. RESULTS In the baseline analysis, DPR varied from 1.55 (in Russia) to 2.60 (in the UK). The sensitivity analysis of the unit costs of emetic episodes and rescue medication identified a range from 1.39 (in Germany) to 4.09 (in Russia). Even in the least favourable clinical scenario, palonosetron was a preferred antiemetic strategy with a DPR >1 in all five countries. CONCLUSIONS This is the first economic evaluation analysis of palonosetron. The results demonstrate that palonosetron, because of its superior clinical efficacy in controlling emesis, could have a favourable DPR when compared with ondansetron in all five countries considered and still offer lower or equal net treatment costs for the hospital.
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Ihbe-Heffinger A, Ehlken B, Bernard R, Berger K, Peschel C, Eichler HG, Deuson R, Thödtmann J, Lordick F. The impact of delayed chemotherapy-induced nausea and vomiting on patients, health resource utilization and costs in German cancer centers. Ann Oncol 2004; 15:526-36. [PMID: 14998860 DOI: 10.1093/annonc/mdh110] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Delayed chemotherapy-induced nausea and vomiting (CINV) remains a major adverse effect of cancer chemotherapy. We assessed, under current practice patterns, the occurrence and impact on healthcare resource utilization of CINV in patients receiving emetogenic chemotherapy. An additional aim of this study was to estimate costs imputable to CINV in the German healthcare environment. MATERIALS AND METHODS This prospective, multi-center, cross-sectional cost-of-illness study was conducted in three hospitals and in three office-based facilities in Germany. Consecutive patients undergoing emetogenic chemotherapy (levels 4 or 5 according to Hesketh classification of emetogenicity) were enrolled. Data were obtained from preplanned chart reviews and from self-administered patient questionnaires. Analysis of direct costs was performed from the perspectives of third party payer (statutory sick fund), provider (hospital) and patients. Indirect costs were assessed on the basis of paid workdays lost. RESULTS During the 5-day observation period, 134 of 208 chemotherapy cycles observed (64.4%) were associated with at least one episode of nausea or vomiting. More patients experienced delayed than acute CINV (60.7% versus 32.8%), and more patients reported nausea than vomiting (62.5% versus 26.0%). A total of 68 patients (32.6%) utilized healthcare resources due to CINV. The most frequently used resources were rescue medications and outpatient hospital and office physician visits. Only one patient required hospitalization and only three patients lost workdays due to CINV. Average costs imputable to CINV per patient (with or without CINV) per treatment cycle incurred by third party payers and hospital providers were Euro 49 and Euro 48, respectively. Patient or treatment characteristics that were associated with high costs imputable to CINV were as follows: cisplatin-containing regimen; experience of emesis; and presence of delayed CINV. CONCLUSIONS A substantial proportion of patients continue to experience CINV. This entails not only clinical but also economic consequences, and highlights a continuing need for improved utilization of existing antiemetic agents and for new, more efficacious treatments. The greatest improvements in patient care and potential for cost offset may be realized by preventing delayed CINV.
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Affiliation(s)
- A Ihbe-Heffinger
- Department of Pharmacy, Klinikum rechts der Isar, Technische Universität München, Germany.
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Ballatori E, Roila F. Impact of nausea and vomiting on quality of life in cancer patients during chemotherapy. Health Qual Life Outcomes 2003; 1:46. [PMID: 14521717 PMCID: PMC212194 DOI: 10.1186/1477-7525-1-46] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2003] [Accepted: 09/17/2003] [Indexed: 11/12/2022] Open
Abstract
It is commonly claimed that the nausea and vomiting accompanying cytotoxic chemotherapy have a negative impact on health-related quality of life. While this may seem self-evident, until a few years ago there was little empirical data demonstrating that the failure to control postchemotherapy emesis affects aspects of quality of life. In spite of their limitations, several observational studies showed that nausea and vomiting associated with chemotherapy induced a decrease in health-related quality of life with respect to patients without nausea and vomiting. This has also been demonstrated after the adjustment for health-related quality of life before chemotherapy that is an important prognostic factor of chemotherapy-induced nausea and vomiting. Furthermore, one study suggests that the optimal time of assessment of quality of life to evaluate the impact of chemotherapy-induced nausea and vomiting is day 4 if a 3-day recall period is used or day 8 when the recall period is 7 days. In double-blind studies the efficacy, tolerability and impact on quality of life of the 5-HT3 receptor antagonists was superior with respect to metoclopramide, alizapride and prochlorperazine. Similar results have been achieved with the combination of ondansetron with dexamethasone, the standard treatment for the prevention of acute emesis induced by moderately emetogenic chemotherapy, with respect to the metoclopramide plus dexamethasone combination. Instead, in another double-blind study, in patients submitted to moderately emetogenic chemotherapy, a 5-HT3 antagonist did not seem to significantly increase complete protection from delayed emesis and the patients' quality of life with respect to dexamethasone alone. In conclusion, the evaluation of quality of life in randomized trials comparing different antiemetic drugs for the prevention of chemotherapy-induced nausea and vomiting can add important information useful for the choice of the optimal antiemetic treatment.
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Affiliation(s)
- Enzo Ballatori
- Medical Statistics Unit, Dept. of Internal Medicine and Public Health, University, P. le Tommasi 2, L'Aquila, Italy
| | - Fausto Roila
- Medical Oncology Division, Policlinico Hospital, Via Brunamonti 51, 06122 Perugia, Italy
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Dibble SL, Isreal J, Nussey B, Casey K, Luce J. Delayed chemotherapy-induced nausea in women treated for breast cancer. Oncol Nurs Forum 2003; 30:E40-7. [PMID: 12692669 DOI: 10.1188/03.onf.e40-e47] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe the experience and intensity of delayed nausea in women undergoing chemotherapy for breast cancer since the advent of the 5-HT3 antagonists. DESIGN Multisite, longitudinal, descriptive. SETTING 7 outpatient oncology clinics situated in hospitals, 5 outpatient oncology clinics associated with major teaching universities, 27 private outpatient oncology practices, and 1 outpatient clinic located in a county hospital. SAMPLE Typical participants (N = 303) were 51.9 years old, Caucasian (79%), married or partnered (65%), born U.S. citizens (92%), heterosexual (96%), living with someone (83%), and high school graduates (82%). METHODS Baseline and poststudy questionnaires plus a daily diary of nausea through two cycles of chemotherapy (approximately two months) were used to collect data. The Rhodes Inventory of Nausea, Vomiting, and Retching was used to assess the nausea experience. MAIN RESEARCH VARIABLES Nausea. FINDINGS The worst nausea occurred on the third day after having chemotherapy for breast cancer. The types of oral antiemetics ordered for home use were changed between the two cycles of the study only 8% (n = 24) of the time. Younger, heavier women experienced more delayed nausea. Women who had a history of nausea with stress and women receiving cyclophosphamide experienced more delayed nausea during both time periods. CONCLUSIONS Delayed nausea is a significant problem for women receiving chemotherapy for breast cancer. IMPLICATION FOR NURSING: Oncology nurses can use the results from this study to provide anticipatory guidance for patients undergoing chemotherapy for breast cancer.
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Affiliation(s)
- Suzanne L Dibble
- Institute for Health and Aging, University of California, San Francisco, CA, USA.
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Stieler JM, Reichardt P, Riess H, Oettle H. Treatment Options for Chemotherapy-Induced Nausea and Vomiting. ACTA ACUST UNITED AC 2003. [DOI: 10.2165/00024669-200302010-00002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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