Chemotherapy induced nausea and vomiting (CINV) can have significant physical and psychological consequences for patients and impact on treatment decisions and surveillance compliance. CINV risk assessment and prophylaxis can minimise this clinical risk.
Objective
To measure:
• CINV in patients receiving moderately emetogenic chemotherapy (MEC)
• Compliance with evidence based standards of care to prevent CINV
• Three common side effects of antiemetic
Method:
A convenience sample of 39 patients receiving MEC regimens for ovarian, colorectal or lung cancer over a four month period in 2014 were invited to participate in the study. The CINV Check audit was used to measure three standards. Additional questions relating to side effects of antiemetics were added. Patients recorded their experience in a diary. Thirty-four diaries were analysed for incidence of CINV and side effects of antiemetics. Thirty-three medical records were reviewed in relation CINV prophylaxis standards.
Results: CINV risk assessment was evident in 27% of medical records. 58% of patients reported CINV. 74% experienced nausea only: 5% acute CINV and 95% delayed CINV. Additionally, 85% reported their CINV to staff prior to their next cycle and 29% did not have their antiemetic therapy optimised prior to next cycle. Fifty-five percent reported that CINV had a negative impact on quality of life; 55% experienced constipation; 52% reported sleep disturbance and 75 % diabetic patients experienced increase in blood glucose.
Conclusion:Consistent with current literature, chemotherapy induced vomiting is relatively well controlled with appropriate antiemetic; however nausea continues to be a significant clinical risk which requires our attention and further clinical management.