Abstract:
ackground: Chemotherapy-induced nausea and vomiting are among the most feared side effects by the patients. Among them delayed chemotherapy-induced nausea and vomiting can impair patients' quality of life and poor control of nausea and vomiting can interrupt or force withdrawal from patients' chemotherapy.
Objective: This study was aimed to assess the incidence of chemotherapy-induced nausea and vomiting, and its impact on patients' quality of life after taking highly and moderately emetogenic chemotherapeutic agents in cancer centers, in northwest Ethiopia; in 2023.
Method: A prospective observational study was conducted among cancer patients taking high and moderately emetogenic chemotherapy (n=386) at the oncology centers of northwest Ethiopia. After identifying patients who received high and moderate emetogenic chemotherapy, they were followed for six days. One day for acute chemotherapy-induced nausea and vomiting, 2 to 5 days for delayed chemotherapy-induced nausea and vomiting, and day six to measure the impact of nausea and vomiting due to chemotherapy on the patient's quality of life. The chemotherapy-induced nausea and vomiting incidence was assessed using a visual analog scale. The impact on the patient’s quality of life was evaluated using an FLIE questionnaire on day 6 through interviews. The data was entered into Epidata software version 4.6 and analyzed by Statistical Package for Social Science version 25, Binary and multivariable logistic regression were used to identify factors associated with chemotherapy-induced nausea and vomiting, reported with 95%, confidence interval(CI), P value < .05 was considered as statistically significant. An independent T-test was done to determine the comparison of group means between FLIE items and emetogenic potential.
Result: Among 386 patients included in the study, the incidence of chemotherapy-induced nausea and vomiting was 68.9% (95% CI, 67.6-72.5), and acute and delayed emesis were reported by (39.6% and 52.8%) respectively. Acute and delayed nausea, (64.2% and 73.0%) respectively, patients taking high emetogenic chemotherapy reported significantly lower total FLIE scores than moderate emetogenic chemotherapy patients (86.9 v 99.4 respectively, p<.001). Patients with motion sickness, AOR=2.15; 95% (1.271-3.654), ECOG, AOR=3.82; 95% (2.28-6.38), HEC, AOR=2.28; 95% (1.35-3.86) and anticipatory nausea and vomiting, AOR=2.13; 95% (1.21-3.77), were factors significantly associated with chemotherapy-induced nausea and vomiting.
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Conclusion: The result of this study showed that the incidence of chemotherapy-induced nausea and vomiting was high in the study area and it significantly affected patients' quality of life despite antiemetic prophylaxis. Motion sickness, performance status, previous anticipatory nausea and vomiting, and emetogenic potential were factors associated with the occurrence of chemotherapy-induced nausea and vomiting. Physicians should give special attention to those patients to reduce the risk of chemotherapy-induced nausea and vomiting. There was a significant mean difference between emetogenic potential on the Total FLIE score and nausea due to high emetogenic chemotherapy strongly impacting patients’ daily lives.
