Prevalence of Chemo-induced Nausea and Vomiting, and Its impact on Patients’ Quality of Life at the Oncology Unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2015-06
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Addis Ababa University
Abstract
Nausea and vomiting remain among the most distressing side effects of treatment with chemotherapy.
Chemotherapy induced emesis (CIE) can impair quality of life (QOL) and poor control of emesis can
interrupt or force withdrawal from critical chemotherapy. The prevalence of chemo-induced nausea and
vomiting (CINV), and its impact on patients’ QOL were not assessed in Ethiopia.The objective of this
study was to assess the prevalence of CINV, and its impact on patients’ QOL after highly or moderately
emetogenic chemotherapy at the oncology unit of Tikur Anbessa Specialized Hospital (TASH).A
descriptive prospective cross sectional study involving interview and case note review were conducted
among patients evaluated and treated at oncology unit of TASH. The incidence of CINV and its impact on
the patients’ daily life were evaluated using the self-assessment tools. Patients who agreed to participate
received a diary covering the day of chemotherapy administration (day 1) and the following 4 days (day 2
through 5). Patients were instructed to use the diary every day to record each emetic episode and to
provide daily nausea assessments using a 100-mm visual analog scale (VAS) to rate the severity of nausea
experienced during the preceding 24 h. Bi variate and Multivariate logistic regression was used to identify
determinants of CINV. Independent t- test was used for comparison of group means between highly
emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC). Differences in the
proportion of patients that reported no impact on daily life (NIDL) between MEC and HEC treated
patients were analyzed using X 2 tests (Fisher’s exact test). A total of 220 patients were assessable (74
HEC patients, 146 MEC patients). Emesis was reported by 64.1% of patients (37.3 % acute, 50 %
delayed) and nausea by 76.8 % (50.5 % acute, 65.5 % delayed). HEC patients reported significantly lower
mean functional living index (FLIE) total score than MEC patients (89.7 v 102.4 respectively; P < .001).
Among all patients, the nausea score was significantly lower than the vomiting score (46.5 and 51.6,
respectively; p < .001).The prevalence of CINV at oncology unit of TASH was found to be high and it
adversely affects patients’ QoL despite antiemetic therapy even after treatment with only moderately
emetogenic chemotherapy regimens. On the basis of the FLIE results in this study, nausea had a stronger
negative impact on patients’ daily lives than vomiting.
Key words:
chemo-induced nausea and vomiting (CINV), highly emetogenic chemotherapy (HEC) , moderately
emetogenic chemotherapy (MEC). impact on daily life (NIDL) , Functional living index (FLIE),
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Keywords
Chemo-induced nausea and vomiting (CINV); Highly emetogenic chemotherapy (HEC); Moderately emetogenic chemotherapy (MEC);Impact on daily life (NIDL) ;Functional living index (FLIE)