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, Kord M. Kober, Anand A. Dhruva, Elena Flowers, Steve M. Paul, Marilyn Hammer, Frances Cartwright, Fay Wright, Yvette P. Conley, Jon D. Levine, Christine Miaskowski

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalJournal of Pain and Symptom Management
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Nausea
Quality of Life
Drug Therapy
Demography
Antiemetics
Serotonin Antagonists
Fatigue
Sleep
Logistic Models
Steroids
Regression Analysis
Depression
Education

Keywords

  • antiemetics
  • cancer
  • chemotherapy
  • Nausea
  • quality of life
  • stress

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Risk Factors Associated With Chemotherapy-Induced Nausea in the Week Before the Next Cycle and Impact of Nausea on Quality of Life Outcomes. / Singh, Komal P.; Kober, Kord M.; Dhruva, Anand A.; Flowers, Elena; Paul, Steve M.; Hammer, Marilyn; Cartwright, Frances; Wright, Fay; Conley, Yvette P.; Levine, Jon D.; Miaskowski, Christine.

In: Journal of Pain and Symptom Management, 01.01.2018.

Research output: Contribution to journalArticle

Singh, Komal P. ; Kober, Kord M. ; Dhruva, Anand A. ; Flowers, Elena ; Paul, Steve M. ; Hammer, Marilyn ; Cartwright, Frances ; Wright, Fay ; Conley, Yvette P. ; Levine, Jon D. ; Miaskowski, Christine. / Risk Factors Associated With Chemotherapy-Induced Nausea in the Week Before the Next Cycle and Impact of Nausea on Quality of Life Outcomes. In: Journal of Pain and Symptom Management. 2018.
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title = "Risk Factors Associated With Chemotherapy-Induced Nausea in the Week Before the Next Cycle and Impact of Nausea on Quality of Life Outcomes",
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 = "antiemetics, cancer, chemotherapy, Nausea, quality of life, stress",
author = "Singh, {Komal P.} and Kober, {Kord M.} and Dhruva, {Anand A.} and Elena Flowers and Paul, {Steve M.} and Marilyn Hammer and Frances Cartwright and Fay Wright and Conley, {Yvette P.} and Levine, {Jon D.} and Christine Miaskowski",
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T1 - Risk Factors Associated With Chemotherapy-Induced Nausea in the Week Before the Next Cycle and Impact of Nausea on Quality of Life Outcomes

AU - Singh, Komal P.

AU - Kober, Kord M.

AU - Dhruva, Anand A.

AU - Flowers, Elena

AU - Paul, Steve M.

AU - Hammer, Marilyn

AU - Cartwright, Frances

AU - Wright, Fay

AU - Conley, Yvette P.

AU - Levine, Jon D.

AU - Miaskowski, Christine

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - antiemetics

KW - cancer

KW - chemotherapy

KW - Nausea

KW - quality of life

KW - stress

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