The impact of chemotherapy-induced nausea and vomiting on health-related quality of life

Ballatori, Enzo; Roila, Fausto; Ruggeri, Benedetta; Betti, Maura; Sarti, Samanta; Soru, Giancarla; Cruciani, Giorgio; Maïo, Massimo Di; Andrea, Biffi; Deuson, Robert

doi:10.1007/s00520-006-0109-7

Cited by 122 publications

(89 citation statements)

References 25 publications

(15 reference statements)

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“…Nausea is, from the patients' own perspective, even more negative than vomiting, while, in contrast, medical providers tend to consider their patients' vomiting worse than nausea, with the risk to underestimate the latter [6,7] . CINV has extremely negative consequences by reducing daily functioning and quality of life (QoL) [8][9][10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

Role of Psychosocial Variables on Chemotherapy-Induced Nausea and Vomiting and Health-Related Quality of Life among Cancer Patients: A European Study

Grassi

Berardi

Ruffilli

et al. 2015

Psychother Psychosom

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Background: Chemotherapy-induced nausea and vomiting (CINV) continue to be a distressing problem still reported by cancer patients, with negative consequences on quality of life (QoL). Aims: To prospectively explore the association of psychosocial variables, including emotional distress, maladaptive coping styles and the doctor-patient relationship, with CINV and QoL among cancer outpatients. Methods: A prospective study was conducted on 302 consecutive cancer patients (response rate 80.9%) in Austria, Italy and Spain. The Distress Thermometer (DT), the Mini-Mental Adjustment to Cancer (Mini-MAC), and the Patient Satisfaction with Doctor Questionnaire (PSQ) were used to assess psychosocial variables before chemotherapy. In the 5 days after chemotherapy, CINV was examined by using a daily diary, and the Functional Living Index for Emesis (FLIE) was used to assess QoL. Results: More than half of the patients reported nausea (54%), and a small percentage reported vomiting (14%). CINV had a negative impact on QoL (FLIE caseness, p < 0.01). Maladaptive coping (i.e. hopelessness-helplessness and anxious preoccupation) and emotional distress were associated with CINV (p < 0.05) and poorer QoL (p < 0.05). In logistic regression analysis, nausea was predicted by Mini-MAC/H (OR = 1.1, p = 0.03) and younger age (OR = 0.97, p = 0.04); negative impact on QoL was predicted by grade of chemotherapy emetogenesis (OR = 1.7, p < 0.01) and Mini-MAC/H (OR = 1.2, p = 0.04). Conclusions: Screening and assessment of psychological variables, especially coping, could help in identifying cancer patients at risk for chemotherapy-induced nausea, in spite of the use of antiemetic treatment.

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Section: Introductionmentioning

confidence: 99%

Role of Psychosocial Variables on Chemotherapy-Induced Nausea and Vomiting and Health-Related Quality of Life among Cancer Patients: A European Study

Grassi

Berardi

Ruffilli

et al. 2015

Psychother Psychosom

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“…Benché la quantificazione dei costi e dell'impatto di CINV nella pratica clinica sia di estrema importanza per l'allocazione delle risorse nei confronti di nuove terapie antiemetiche, gli studi che trattano il costo di malattia sono abbastanza ridotti [16][17][18][19][20] parte dei lavori tende a prendere in esame gli aspetti farmacoeconomici di un singolo antiemetico, e spesso solo in relazione alla CINV in fase acuta. L'unico studio specifico che ha valutato il costo di malattia nella realtà italiana che siamo riusciti a reperire è il lavoro di Ballatori e coll.…”

Section: Costo DI Malattiaunclassified

Palonosetron in the prevention of chemotherapy-induced nausea and vomiting in Italy: pharmacoeconomic and clinical aspects

Pradelli

Eandi

2007

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Despite considerable improvements in the last two decades, chemotherapy-induced nausea and vomiting (CINV) remains a frequent and very bothersome medical problem. It is estimated that about one half to two thirds of all chemotherapy-treated patients experience CINV, the frequency depending on the chemotherapy regimen used and on patient-specific features. The impact of CINV, which may be acute, delayed or even anticipatory in experienced patients, on health-related quality of life (HRQoL) is substantial in all domains. Until recently, effective treatment choices included corticosteroids and first-generation 5-HT 3 antagonists, which have been supported by aprepitant, the first clinically available NK1 antagonist, and by palonosetron, considered the first second-generation 5-HT 3 antagonist for its high receptor-subtype selectivity and affinity and long plasmatic half-life. In this paper, clinical pharmacology of the latter drug is briefly outlined and recent Italian papers on the epidemiology and HRQoL impact of CINV are reviewed, as well as national pharmacoeconomic evalutations conducted on palonosetron. The role in therapy of palonosteron and its potential for improved clinical, HRQoL and economic outcomes is discussed. Keywords: chemotherapy-induced nausea and vomiting (CINV), HRQoL, palonosetronPalonosetron nella prevenzione della CINV in Italia: aspetti farmacologici clinici e farmacoeconomici Lorenzo Pradelli (1) , Mario Eandi (2) Farmeconomia e percorsi terapeutici 2007; 8(2): 71-80dalla somministrazione della chemioterapia. Nausea e vomito sono in genere di intensità maggiore nelle prime 5-6 ore;ritardati: insorgono dopo almeno 24 ore dalla somministrazione (quindi il secondo giorno) e durano fino a 5-7 giorni. La frequenza degli attacchi può essere addirittura maggiore rispetto a quella osservata il giorno stesso del trattamento chemioterapico;anticipatori: si manifesta nel giorno o nelle ore che precedono la chemioterapia. La corretta gestione della CINV, essenzialmente rappresentata da un adeguata profilassi, riveste un'importanza estrema per fornire al paziente maggior benessere e per consentire una maggiore aderenza alla terapia. È cruciale che la profilassi venga attuata con i farmaci più efficaci e adeguati allo schema chemioterapico già dal primo ciclo, in quanto l'esperienza di emesi e nausea è di per sé un fattore favorente lo sviluppo di CINV ritardato nei cicli successivi [1].La patogenesi della CINV non è completamente chiarita e coinvolge probabilmente molti differenti siti d'azione, anche in funzione del particolare agente chemioterapico utilizzato --La nausea e il vomito indotti da chemioterapia (Chemotherapy-induced nausea and vomiting, CINV) sono tra gli effetti collaterali più comuni e gravosi correlati alla terapia antineoplastica. Circa i tre quarti di tutti i pazienti sottoposti a chemioterapia ne soffrono. L'incidenza di questi sintomi dipende in gran parte dal farmaco antineoplastico scelto e dal suo dosaggio; il cisplatino, ad esempio, uno dei chemioterapici più frequen...

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“…Studies have shown that chemotherapy-induced nausea and vomiting reduce well-being [11], quality of life [3,30,32], performance of daily activities [30,33,34], ability to socially interact [30] and increases anxiety and low mood [43]. However, [30] radiotherapy-induced nausea is generally less frequent and less severe than chemotherapy-induced nausea [42] and it is not known to what extent these findings are also valid for patients with nausea during radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

One third of patients with radiotherapy-induced nausea consider their antiemetic treatment insufficient

Enblom

Axelsson

Steineck

et al. 2008

Support Care Cancer

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Objective To describe the prevalence of nausea and vomiting during radiotherapy and to compare quality of life, psychological and functional status in patients experiencing or not experiencing nausea.Materials and methods A cross-sectional selection of 368 cancer patients treated with radiotherapy answered a questionnaire (=93% answering rate) regarding nausea, vomiting, actual use of and interest in antiemetic treatment, quality of life and psychological and functional status during the preceding week of radiotherapy. Mean age was 60 years and 66% were women. Main results Nausea was experienced by 39% (145) and vomiting by 7% (28) of patients in general, by 63% in abdominal or pelvic fields and by 48% in head/neck/brain fields. Abdominal/pelvic field (Relative risk (RR) 2.0), age ≤40 years (RR 1.9) and previous nausea in other situations (RR 1.8) implied an increased risk for nausea. Antiemetics were used by 17% and 78% were interested in or wanted more information about acupuncture treatment against nausea. Of the 145 nauseous patients only 25% felt that antiemetics had helped them and 34% would have liked additional treatment, although the nausea intensity was mild in 72%. The nauseous patients reported lower well-being and quality of life, lower satisfaction with aspects of daily living and more frequent anxiety and depressed mood than the patients without nausea. Conclusions Of all patients undergoing radiotherapy, 39% experienced nausea and one third of them would have liked more treatment against the nausea. This study stresses the importance to identify and adequately treat patients with increased risk for nausea related to radiotherapy.

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The impact of chemotherapy-induced nausea and vomiting on health-related quality of life

Abstract: 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.

Cited by 122 publications

References 25 publications

Role of Psychosocial Variables on Chemotherapy-Induced Nausea and Vomiting and Health-Related Quality of Life among Cancer Patients: A European Study

Role of Psychosocial Variables on Chemotherapy-Induced Nausea and Vomiting and Health-Related Quality of Life among Cancer Patients: A European Study

Palonosetron in the prevention of chemotherapy-induced nausea and vomiting in Italy: pharmacoeconomic and clinical aspects

One third of patients with radiotherapy-induced nausea consider their antiemetic treatment insufficient

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