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. 2018 Sep;56(3):352-362.
doi: 10.1016/j.jpainsymman.2018.05.019. Epub 2018 May 30.

Risk Factors Associated With Chemotherapy-Induced Nausea in the Week Before the Next Cycle and Impact of Nausea on Quality of Life Outcomes

Komal P Singh  1 , Kord M Kober  1 , Anand A Dhruva  2 , Elena Flowers  1 , Steve M Paul  1 , Marilyn J Hammer  3 , Frances Cartwright  3 , Fay Wright  4 , Yvette P Conley  5 , Jon D Levine  2 , Christine Miaskowski  6
Affiliations

Risk Factors Associated With Chemotherapy-Induced Nausea in the Week Before the Next Cycle and Impact of Nausea on Quality of Life Outcomes

Komal P Singh et al. J Pain Symptom Manage. 2018 Sep.

Abstract

Context: Despite current advances in antiemetic treatments, between 19% and 58% of oncology patients experience chemotherapy-induced nausea (CIN).

Objectives: Aims of this post hoc exploratory analysis were to determine occurrence, severity, and distress of CIN and evaluate for differences in demographic and clinical characteristics, symptom severity, stress; and quality of life (QOL) outcomes between oncology patients who did and did not report CIN in the week before chemotherapy (CTX). Demographic, clinical, symptom, and stress characteristics associated with CIN occurrence were determined.

Methods: Patients (n = 1296) completed questionnaires that provided information on demographic and clinical characteristics, symptom severity, stress, and QOL. Univariate analyses evaluated for differences in demographic and clinical characteristics, symptom severity, stress, and QOL scores between the two patient groups. Multiple logistic regression analysis was used to evaluate for factors associated with nausea group membership.

Results: Of the 1296 patients, 47.5% reported CIN. In the CIN group, 15% rated CIN as severe and 23% reported high distress. Factors associated with CIN included less education; having childcare responsibilities; poorer functional status; higher levels of depression, sleep disturbance, evening fatigue, and intrusive thoughts; as well as receipt of CTX on a 14-day CTX cycle and receipt of an antiemetic regimen that contained serotonin receptor antagonist and steroid. Patients in the CIN group experienced clinically meaningful decrements in QOL.

Conclusion: This study identified new factors (e.g., poorer functional status, stress) associated with CIN occurrence. CIN negatively impacted patients' QOL. Pre-emptive and ongoing interventions may alleviate CIN occurrence in high-risk patients.

Keywords: Nausea; antiemetics; cancer; chemotherapy; quality of life; stress.

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Figures

Figure 1:
Figure 1:
Percentage of patients who reported each severity (A) and distress (B) rating for nausea on the Memorial Symptom Assessment Scale
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