Congress Abstracts 2006

246

EFFECTS OF ACUTE AND DELAYED CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING ON QUALITY OF LIFE IN WOMEN WITH BREAST CANCER. Regina Cunningham, PhD, RN, AOCN^®, UMDNJ-Robert Wood Johnson Medical School, The Cancer Institute of New Jersey, New Brunswick, NJ; and Henry Hu, MD, PhD, and Ya-Ting Chen, PhD, Merck, West Point, PA.

Acute and delayed chemotherapy-induced nausea and vomiting (CINV) are among the most common and distressing side effects of therapy in women receiving treatment for breast cancer. This patient population has specific risk factors that predispose them to the development of CINV. Little is known about the incidence of CINV, use of antiemetics, and effect on quality of life (QOL) outcomes in women treated for breast cancer in the community oncology setting.

The purpose of this investigation was to determine the incidence of acute and delayed CINV, identify antiemetic usage patterns, and assess the effect of CINV on QOL outcomes in a sample of women receiving breast cancer treatment in the community oncology setting.

The conceptual model used to guide this investigation is based on the work of Donabedian who identified the structure, process, outcome trilogy as essential components of the measurement of quality in health care. Outcomes represent the consequences of the structure and process of care on the health and welfare of recipients of that care. In this investigation, the community setting represents a structural variable, patterns of antiemetic usage represents a process variable, and incidence of CINV and QOL are the outcomes under investigation.

This was a prospective observational study. Eligibility criteria included: aged 18 or greater; histologically confirmed breast cancer receiving chemotherapy; no history of emesis during the 24 hours preceding chemotherapy; no concomitant meds that would induce nausea or vomiting; no concurrent therapy (radiation, hormonal therapy). Demographics and risk factors were self-reported. Community oncologists provided chemotherapy and antiemetic regimen data. Incidence of CINV and QOL were assessed using the Functional Living Index-Emesis (FLIE) Incidence and QOL were measured days 1 and 2-4 post chemotherapy.

The study enrolled 461 women. The mean age was 54.4 (SD 10.6 years). Fifteen percent had received previous chemotherapy. Antiemetic usage varied. Delayed CINV more profoundly affected QOL. Nausea had a greater effect on QOL than did vomiting.

CINV is a common problem in women receiving treatment in the community oncology setting. Some antiemetics are underutilized. Oncology nurses are in a position to make recommendations to optimize antiemetic prophylaxis and improve QOL.