Impact and management of chemotherapy/radiotherapy-induced nausea and vomiting and the perceptual gap between oncologists/oncology nurses and patients: a cross-sectional multinational survey

Support Care Cancer. 2015 Nov;23(11):3297-305. doi: 10.1007/s00520-015-2750-5. Epub 2015 May 8.

Abstract

Purpose: Chemotherapy/radiotherapy-induced nausea and vomiting (CINV/RINV) can affect half of oncology patients, significantly impacting daily life. Nausea without vomiting has only recently been thought of as a condition in its own right. As such, the incidence of nausea is often underestimated. This survey investigated the incidence and impact of CINV/RINV in patients compared with estimations of physicians/oncology nurses to determine if there is a perceptual gap between healthcare professionals and patients.

Methods: An online research survey of physicians, oncology nurses and patients was conducted across five European countries. Participants had to have experience prescribing/recommending or have received anti-emetic medication for CINV/RINV treatment. Questionnaires assessed the incidence and impact of CINV/RINV, anti-emetic usage and compliance, and attribute importance of anti-emetic medication.

Results: A total of 947 (375 physicians, 186 oncology nurses and 386 patients) participated in this survey. The incidence of nausea was greater than vomiting: 60 % of patients reported nausea alone, whereas 18 % reported vomiting. Physicians and oncology nurses overestimated the incidence of CINV/RINV but underestimated its impact on patients' daily lives. Only 38 % of patients reported full compliance with physicians'/oncology nurses' guidelines when self-administering anti-emetic medication. Leading factors for poor compliance included reluctance to add to a pill burden and fear that swallowing itself would induce nausea/vomiting.

Conclusions: There is a perceptual gap between healthcare professionals and patients in terms of the incidence and impact of CINV/RINV. This may lead to sub-optimal prescription of anti-emetics and therefore management of CINV/RINV. Minimising the pill burden and eliminating the requirement to swallow medication could improve poor patient compliance with anti-emetic regimens.

Keywords: Anti-emetic; Chemotherapy/radiotherapy-induced nausea and vomiting; Impact; Incidence; Perceptual gap.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiemetics / therapeutic use*
  • Antineoplastic Agents / adverse effects
  • Cross-Sectional Studies
  • Europe
  • Female
  • Humans
  • Incidence
  • Induction Chemotherapy
  • Male
  • Medication Adherence
  • Middle Aged
  • Nausea / chemically induced
  • Nausea / drug therapy*
  • Nausea / prevention & control
  • Nurse-Patient Relations*
  • Oncology Nursing
  • Physician-Patient Relations*
  • Radiotherapy / adverse effects
  • Surveys and Questionnaires
  • Vomiting / chemically induced
  • Vomiting / drug therapy*
  • Vomiting / prevention & control
  • Young Adult

Substances

  • Antiemetics
  • Antineoplastic Agents