News Release

Patients needlessly suffering from chemotherapy induced nausea and vomiting

New survey identifies need for new nurse awareness and training initiatives

Peer-Reviewed Publication

Shire Hall Communications

Venice, Saturday 13 April, 2002. Nearly two decades after the introduction of highly effective antiemetic (anti-nausea) therapies, almost a third of patients are still suffering from chemotherapy induced nausea and vomiting (CINV). Unmet needs in nurse training may be contributing to this sub-optimal patient care.

Delegates attending the third biannual convention of the European Oncology Nursing Society (EONS) heard for the first time results of a pan-European nurse survey, the aim of which was to identify unmet training and treatment needs in the management of CINV.

The survey highlighted that after hair loss, nausea and vomiting are the two most common concerns expressed by patients when told they require chemotherapy (68% and 57% of respondents respectively).

Nausea and vomiting (emesis) are two of the most common side effects of chemotherapy, affecting about 70% of patients, and representing a major therapeutic challenge in cancer and post-operative care.1

Nausea and vomiting can be extremely uncomfortable and devastating to the quality of life of the patient undergoing treatment – so much so that some patients opt to delay or refuse further potentially life-saving treatment.2, 3 It is generally accepted that full 24 hour coverage from nausea and vomiting is required from anti-emetic treatment strategies if disruption to a patient’s quality of life is to be minimized.

Commenting on the results of the survey, Giel Vaessen, President, EONS, said," The survey has clearly demonstrated an unmet need in patient management and nurse training."

"The high incidence of CINV uncovered by this survey is clearly unacceptable. While inappropriate utilization of anti-emetics significantly contributes to poor CINV control, another key issue is a lack of relevant nurse training. In addition, a low level of awareness of the issue and cultural influences may also be a contributory factor" he concluded.

Trained oncology nurses have a significant influence over treatment strategies with 39% of respondents having a high, and 28% having a moderate involvement in the decision regarding which anti-emetic treatment is used.

Commenting on the role of nurses in supporting better CINV management, Vaessen said, "The significant influence nurses have over treatment of CINV coupled to their high level of patient interaction means that nurses are ideally placed to take a lead in reducing the unacceptably high incidence of CINV.

"Better nurse education, assessment methods, identification of patients who are inadequately controlled and a thorough review of current treatment approaches are urgently needed," he concluded.

The EONS is currently considering the implications of the survey and will be developing a plan of action to support its members in meeting the needs of patients uncovered by the survey. The first stage in the process will be to undertake additional research to further clarify the unmet need in the effective management of CINV.

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References
1. Osoba D, et al., Support Care Cancer 1997; 307-313.
2. Laszlo J, et al., Antiemetics and Cancer Chemotherapy, 1993; 1-5.
3. Schmitt R. Chest, 1993; 51-55.

Editor’s notes:

The EONS is comprised of individual cancer nurses, oncology nursing societies, institutions and agencies involved in cancer care. EONS is dedicated to developing and promoting the practice of cancer nursing in Europe through educational, research, and practice-based initiatives.

The EONS 3rd Spring Convention: Leading the way in cancer care - power of information and knowledge, 11-13 April 2002, Venice, Italy, is an educational, interactive conference geared to provide the cancer nurse with knowledge and skills to better deal with communication and information issues in clinical practice.

The survey, carried out by NOP on behalf of the EONS was supported by an unrestricted educational grant from Roche. The survey was carried out in February 2002, among 180 nurses in six countries: France, Germany, Italy, Netherlands, Spain and UK.

For further information please contact Rupert Doggett, Shire Hall New York: 001 212 725 7522, rdoggett@commonhealth.com


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