Skip to main content
Top
Published in: Supportive Care in Cancer 12/2009

01-12-2009 | Original Article

Reduction of chemotherapy-induced anorexia, nausea, and emesis through a structured nursing intervention: a cluster-randomized multicenter trial

Authors: Patrick Jahn, Petra Renz, Joerg Stukenkemper, Katrin Book, Oliver Kuss, Karin Jordan, Ingrid Horn, Anette Thoke-Colberg, Hans-Joachim Schmoll, Margarete Landenberger

Published in: Supportive Care in Cancer | Issue 12/2009

Login to get access

Abstract

Objectives

The purpose of this present study was to evaluate Self-care Improvement through Oncology Nursing (SCION) program to reduce distressing anorexia, nausea, and emesis (ANE) in cancer patients undergoing chemotherapy.

Methods

Two hundred eight patients receiving chemotherapy with moderate to high emetogenic potential participated in a cluster randomized trial on 14 wards in two German university hospitals. Additionally to standard antiemetic treatment, patients from the intervention wards received the SCION program consisting of four modules: advisory consultation, optimizing emesis prophylaxis, nutrition counseling, and relaxation. Patients from the control group received standard antiemetic treatment and standard care. Primary outcome was the group difference in ANE intensity assessed by Common Terminology Criteria for adverse events (CTCAE).

Main results

The SCION program did not result in a significant difference in the incidence of ANE symptoms as compared to standard care: mean difference on CTCAE scale was 0.24 pts (95%CI, −1.17 to 1.66 pts; P = 0.733). No difference could be found regarding patients’ knowledge of side effects, self-care interventions, and agency. Health-related quality of life was significantly better for patients in the control group (mean difference 10.2 pts; 95%CI, 1.9 to 18.5; P = 0.017).

Conclusions

Contrary to our expectations, the groups did not differ in ANE intensity caused by the overall low acute or delayed symptom intensity. Symptom hierarchy in cancer patients alters and challenges nursing interventions targeting the patients’ self-care strategies.
Literature
1.
go back to reference Aapro MS, Molassiotis A, Olver I (2005) Anticipatory nausea and vomiting. Support Care Cancer 13(2):117–121CrossRefPubMed Aapro MS, Molassiotis A, Olver I (2005) Anticipatory nausea and vomiting. Support Care Cancer 13(2):117–121CrossRefPubMed
2.
go back to reference Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRefPubMed Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRefPubMed
3.
go back to reference Ashbury FD, Findlay H, Reynolds B, McKerracher K (1998) A Canadian survey of cancer patients’ experiences: are their needs being met? J Pain Symptom Manage 16(5):298–306CrossRefPubMed Ashbury FD, Findlay H, Reynolds B, McKerracher K (1998) A Canadian survey of cancer patients’ experiences: are their needs being met? J Pain Symptom Manage 16(5):298–306CrossRefPubMed
4.
go back to reference Baldwin C, Parsons T, Logan S (2007) Dietary advice for illness-related malnutrition in adults. Cochrane Database Syst Rev 1:CD002008PubMed Baldwin C, Parsons T, Logan S (2007) Dietary advice for illness-related malnutrition in adults. Cochrane Database Syst Rev 1:CD002008PubMed
5.
go back to reference Ballatori E, Roila F (2003) Impact of nausea and vomiting on quality of life in cancer patients during chemotherapy. Health Qual Life Outcomes 1:1–11CrossRef Ballatori E, Roila F (2003) Impact of nausea and vomiting on quality of life in cancer patients during chemotherapy. Health Qual Life Outcomes 1:1–11CrossRef
6.
go back to reference Benor DE, Delbar V, Krulik T (1998) Measuring impact of nursing intervention on cancer patients’ ability to control symptoms. Cancer Nurs 21(5):320–334CrossRefPubMed Benor DE, Delbar V, Krulik T (1998) Measuring impact of nursing intervention on cancer patients’ ability to control symptoms. Cancer Nurs 21(5):320–334CrossRefPubMed
7.
go back to reference Borjeson S, Hursti TJ, Tishelman C, Peterson C, Steineck G (2002) Treatment of nausea and emesis during cancer chemotherapy. Discrepancies between antiemetic effect and well-being. J Pain Symptom Manage 24(3):345–358CrossRefPubMed Borjeson S, Hursti TJ, Tishelman C, Peterson C, Steineck G (2002) Treatment of nausea and emesis during cancer chemotherapy. Discrepancies between antiemetic effect and well-being. J Pain Symptom Manage 24(3):345–358CrossRefPubMed
8.
go back to reference Devine EC, Westlake SK (1995) The effects of psychoeducational care provided to adults with cancer: meta-analysis of 116 studies. Oncol Nurs Forum 22(9):1369–1381PubMed Devine EC, Westlake SK (1995) The effects of psychoeducational care provided to adults with cancer: meta-analysis of 116 studies. Oncol Nurs Forum 22(9):1369–1381PubMed
9.
go back to reference Evers G, De Maesschalck L, Brouns G, Isenberg M, Philipsen H (2002) Die ASA-A-Skala für die Selbstbeurteilung. In: Evers G (ed) Professionelle Selbstpflege: Einschätzen-Messen-Anwenden. Huber, Bern, pp 59–89 Evers G, De Maesschalck L, Brouns G, Isenberg M, Philipsen H (2002) Die ASA-A-Skala für die Selbstbeurteilung. In: Evers G (ed) Professionelle Selbstpflege: Einschätzen-Messen-Anwenden. Huber, Bern, pp 59–89
10.
go back to reference Feyer P, Kleeberg UR, Steingraber M, Gunther W, Behrens M (2008) Frequency of side effects in outpatient cancer care and their influence on patient satisfaction—a prospective survey using the PASQOC questionnaire. Support Care Cancer 16(6):567–575CrossRefPubMed Feyer P, Kleeberg UR, Steingraber M, Gunther W, Behrens M (2008) Frequency of side effects in outpatient cancer care and their influence on patient satisfaction—a prospective survey using the PASQOC questionnaire. Support Care Cancer 16(6):567–575CrossRefPubMed
11.
go back to reference Figueroa-Moseley C, Jean-Pierre P, Roscoe JA et al (2007) Behavioral interventions in treating anticipatory nausea and vomiting. J Natl Compr Canc Netw 5(1):44–50PubMed Figueroa-Moseley C, Jean-Pierre P, Roscoe JA et al (2007) Behavioral interventions in treating anticipatory nausea and vomiting. J Natl Compr Canc Netw 5(1):44–50PubMed
12.
13.
go back to reference Griffin AM, Butow PN, Coates AS et al (1996) On the receiving end. V: patient perceptions of the side effects of cancer chemotherapy in 1993. Ann Oncol 7(2):189–195PubMed Griffin AM, Butow PN, Coates AS et al (1996) On the receiving end. V: patient perceptions of the side effects of cancer chemotherapy in 1993. Ann Oncol 7(2):189–195PubMed
14.
go back to reference Grunberg SM, Deuson RR, Mavros P et al (2004) Incidence of chemotherapy-induced nausea and emesis after modern antiemetics. Cancer 100(10):2261–2268CrossRefPubMed Grunberg SM, Deuson RR, Mavros P et al (2004) Incidence of chemotherapy-induced nausea and emesis after modern antiemetics. Cancer 100(10):2261–2268CrossRefPubMed
15.
16.
go back to reference Hesketh PJ (1999) Defining the emetogenicity of cancer chemotherapy regimens: relevance to clinical practice. Oncologist 4(3):191–196PubMed Hesketh PJ (1999) Defining the emetogenicity of cancer chemotherapy regimens: relevance to clinical practice. Oncologist 4(3):191–196PubMed
17.
go back to reference Hofman M, Morrow G, Roscoe J et al (2004) Cancer patients’ expectations of experiencing treatment-related side effects. Cancer 101:851–857CrossRefPubMed Hofman M, Morrow G, Roscoe J et al (2004) Cancer patients’ expectations of experiencing treatment-related side effects. Cancer 101:851–857CrossRefPubMed
18.
go back to reference Ihbe-Heffinger A, Ehlken B, Bernard R et al (2004) The impact of delayed chemotherapy-induced nausea and vomiting on patients, health resource utilization and costs in German cancer centers. Ann Oncol 15(3):526–536CrossRefPubMed Ihbe-Heffinger A, Ehlken B, Bernard R et al (2004) The impact of delayed chemotherapy-induced nausea and vomiting on patients, health resource utilization and costs in German cancer centers. Ann Oncol 15(3):526–536CrossRefPubMed
19.
go back to reference Knobf MT (2007) Psychosocial responses in breast cancer survivors. Sem Oncol Nurs 23(1):71–83CrossRef Knobf MT (2007) Psychosocial responses in breast cancer survivors. Sem Oncol Nurs 23(1):71–83CrossRef
20.
go back to reference Kris MG, Hesketh PJ, Somerfield MR et al (2006) American Society of Clinical Oncology Guideline for Antiemetics in Oncology: update 2006. J Clin Oncol 24(18):2932–2947CrossRefPubMed Kris MG, Hesketh PJ, Somerfield MR et al (2006) American Society of Clinical Oncology Guideline for Antiemetics in Oncology: update 2006. J Clin Oncol 24(18):2932–2947CrossRefPubMed
21.
go back to reference Lakusta CM, Atkinson MJ, Robinson JW, Nation J, Taenzer PA, Campo MG (2001) Quality of life in ovarian cancer patients receiving chemotherapy. Gynecol Oncol 81(3):490–495CrossRefPubMed Lakusta CM, Atkinson MJ, Robinson JW, Nation J, Taenzer PA, Campo MG (2001) Quality of life in ovarian cancer patients receiving chemotherapy. Gynecol Oncol 81(3):490–495CrossRefPubMed
22.
go back to reference McQuellon RP, Wells M, Hoffman S et al (1998) Reducing distress in cancer patients with an orientation program. Psychooncology 7(3):207–217CrossRefPubMed McQuellon RP, Wells M, Hoffman S et al (1998) Reducing distress in cancer patients with an orientation program. Psychooncology 7(3):207–217CrossRefPubMed
23.
go back to reference Milne AC, Potter J, Avenell A (2005) Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev 2:CD003288PubMed Milne AC, Potter J, Avenell A (2005) Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev 2:CD003288PubMed
24.
go back to reference Murray D (1998) Design and analysis of group-randomized trials. Oxford University Press, New York Murray D (1998) Design and analysis of group-randomized trials. Oxford University Press, New York
25.
go back to reference Osoba D, Zee B, Warr D, Latreille J, Kaizer L, Pater J (1997) Effect of postchemotherapy nausea and vomiting on health-related quality of life. The quality of life and symptom control committees of the National Cancer Institute of Canada clinical trials group. Support Care Cancer 5(4):307–313CrossRefPubMed Osoba D, Zee B, Warr D, Latreille J, Kaizer L, Pater J (1997) Effect of postchemotherapy nausea and vomiting on health-related quality of life. The quality of life and symptom control committees of the National Cancer Institute of Canada clinical trials group. Support Care Cancer 5(4):307–313CrossRefPubMed
26.
go back to reference Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME (2005) Dietary counseling improves patient outcomes: a prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy. J Clin Oncol 23(7):1431–1438CrossRefPubMed Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME (2005) Dietary counseling improves patient outcomes: a prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy. J Clin Oncol 23(7):1431–1438CrossRefPubMed
27.
go back to reference RCN (2002) Principles for best practice in clinical audit. National Institute for Clinical Excellence, London RCN (2002) Principles for best practice in clinical audit. National Institute for Clinical Excellence, London
28.
go back to reference Roila F, Hesketh PJ, Herrstedt J (2006) Prevention of chemotherapy- and radiotherapy-induced emesis: results of the 2004 Perugia International Antiemetic Consensus Conference. Ann Oncol 17(1):20–28CrossRefPubMed Roila F, Hesketh PJ, Herrstedt J (2006) Prevention of chemotherapy- and radiotherapy-induced emesis: results of the 2004 Perugia International Antiemetic Consensus Conference. Ann Oncol 17(1):20–28CrossRefPubMed
29.
go back to reference Roscoe JA, Bushunow P, Morrow GR et al (2004) Patient expectation is a strong predictor of severe nausea after chemotherapy: a University of Rochester Community Clinical Oncology Program study of patients with breast carcinoma. Cancer 101(11):2701–2708CrossRefPubMed Roscoe JA, Bushunow P, Morrow GR et al (2004) Patient expectation is a strong predictor of severe nausea after chemotherapy: a University of Rochester Community Clinical Oncology Program study of patients with breast carcinoma. Cancer 101(11):2701–2708CrossRefPubMed
30.
go back to reference Rothwell PM (2005) Treating individuals 2. Subgroup analysis in randomised controlled trials: importance, indications, and interpretation. Lancet 365(9454):176–86CrossRefPubMed Rothwell PM (2005) Treating individuals 2. Subgroup analysis in randomised controlled trials: importance, indications, and interpretation. Lancet 365(9454):176–86CrossRefPubMed
31.
go back to reference Tanghe A, Vandekerckhove L, Bras L et al (2002) Der Selbstpflege-Fragebogen für Beschwerden durch Chemotherapie. In: Evers G (ed) Professionelle Selbstpflege: Einschätzen-Messen-Anwenden. Hans Huber, Bern, pp 263–287 Tanghe A, Vandekerckhove L, Bras L et al (2002) Der Selbstpflege-Fragebogen für Beschwerden durch Chemotherapie. In: Evers G (ed) Professionelle Selbstpflege: Einschätzen-Messen-Anwenden. Hans Huber, Bern, pp 263–287
32.
go back to reference Tipton JM, McDaniel RW, Barbour L et al (2007) Putting evidence into practice: evidence-based interventions to prevent, manage, and treat chemotherapy-induced nausea and vomiting. Clin J Oncol Nurs; 11(1):69–78CrossRefPubMed Tipton JM, McDaniel RW, Barbour L et al (2007) Putting evidence into practice: evidence-based interventions to prevent, manage, and treat chemotherapy-induced nausea and vomiting. Clin J Oncol Nurs; 11(1):69–78CrossRefPubMed
33.
go back to reference Williams SA, Schreier AM (2004) The effect of education in managing side effects in women receiving chemotherapy for treatment of breast cancer. Oncol Nurs Forum 31(1):E16–E23CrossRefPubMed Williams SA, Schreier AM (2004) The effect of education in managing side effects in women receiving chemotherapy for treatment of breast cancer. Oncol Nurs Forum 31(1):E16–E23CrossRefPubMed
Metadata
Title
Reduction of chemotherapy-induced anorexia, nausea, and emesis through a structured nursing intervention: a cluster-randomized multicenter trial
Authors
Patrick Jahn
Petra Renz
Joerg Stukenkemper
Katrin Book
Oliver Kuss
Karin Jordan
Ingrid Horn
Anette Thoke-Colberg
Hans-Joachim Schmoll
Margarete Landenberger
Publication date
01-12-2009
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 12/2009
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-009-0698-z

Other articles of this Issue 12/2009

Supportive Care in Cancer 12/2009 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine