Evidence-Based Practice
Carlton G. Brown, PhD, RN, AOCN®, FAAN—Associate Editor
A Nurse-Led Evidence-Based Practice Project to Monitor and Improve the Management of Chemotherapy-Induced Nausea and Vomiting Meghan L. Underhill, PhD, RN, AOCNS®, Lisa Chicko, RN, BA, OCN®, and Donna L. Berry, PhD, RN, AOCN®, FAAN
Chemotherapy-induced nausea and vomiting (CINV) is a common and severe symptom experienced by patients undergoing cancer treatment during the acute or delayed period. Individual characteristics can compound risk for CINV. Identification of risk factors for CINV and structured, nurse-led telephone follow-up are effective, evidence-based methods to support patients undergoing cancer treatment. The authors successfully implemented a structured, nurse-led CINV intervention to improve assessment, follow-up, and support for 30 patients undergoing chemotherapy within an adult ambulatory oncology clinic. At a Glance • CINV is a common and severe symptom for patients undergoing chemotherapy. • A nurse-led assessment and telephone follow-up intervention was able to successfully monitor patient-reported CINV during the acute and delayed periods. • A structured, nurse-led telephone intervention is a feasible way to allow patients to report symptoms outside of a clinical visit. Meghan L. Underhill, PhD, RN, AOCNS®, is a nurse scientist at the Phyllis F. Cantor Center for Research in Nursing and Patient Care Services at the Dana-Farber Cancer Institute in Boston, MA; Lisa Chicko, RN, BA, OCN®, is an infusion charge nurse at Dana-Farber/New Hampshire Oncology-Hematology in Londonderry; and Donna L. Berry, PhD, RN, AOCN®, FAAN, is an associate professor at the Phyllis F. Cantor Center for Research in Nursing and Patient Care Services at the Dana-Farber Cancer Institute. The authors take full responsibility for the content of the article. Funding for the work completed by M. Underhill was provided through the Phyllis F. Cantor Center. No financial relationships relevant to the content of this article have been disclosed by the editorial staff. Underhill can be reached at [email protected], with copy to editor at [email protected]. Key words: chemotherapy-induced nausea and vomiting; evidence-based practice; intervention Digital Object Identifier: 10.1188/15.CJON.38-40
C
hemotherapy-induced nausea and vomiting (CINV) are common and severe symptoms experienced by more than 50% of patients undergoing cancer treatment (Grunberg, 2012). CINV can occur in the acute period, defined as the initial 24 hours after treatment, or the delayed period, defined as 48–72 hours after treatment. Patients treated for cancer in ambulatory cancer settings will experience delayed CINV outside of the clinical setting where selfcare and medication self-administration are required to manage CINV. 38
Chemotherapy regimens are categorized based on level of emetogenicity (Roila et al., 2010), and typical antiemetic treatments are tailored based on mild-, moderate-, or high-level categories. In addition to the emetogenicity of the drug, certain personal characteristics place a patient at increased risk for CINV. These factors include female gender, aged 60 years or younger, minimal alcohol use, and past experiences with motion sickness, CINV, or chemotherapy (Pirri et al., 2011; Thompson, 2012). In addition, anticipatory CINV, or having an expecta-
tion that CINV will occur, is known to predispose a patient to CINV (Molassiotis et al., 2014; Roscoe, Morrow, Aapro, Molassiotis, & Olver, 2011). Treatments for CINV have improved with new medication regimens, but the symptom often may be underreported or undertreated when the patient is outside of the clinic during the acute or delayed symptom experience. Therefore, providing a mechanism for patients to receive support outside of the clinic appointment is important. Structured, nurse-led telephone follow-up and support, in addition to interdisciplinary management of symptoms, can improve patient-reported symptom outcomes (Anderson, 2010; Aranda et al., 2012; Craven, Hughes, Burton, Saunders, & Molassiotis, 2013; Cusack & Taylor, 2010; Kimman et al., 2011).
Study Objectives The primary study objective was to evaluate the process of implementing a structured, nurse-led assessment and telephone follow-up intervention. The authors describe participant enrollment, attrition and completion rates in the study, frequency of completion of nurse-led telephone follow-up, and time to complete the follow-up. A secondary objective was to evaluate the occurrence of acute and delayed CINV in the sample, describe the frequency of anticipatory CINV, and describe frequency of changes in antiemetic prescription after the nurse-led intervention.
Methods The current study included a descriptive, evidence-based practice project conducted at a community ambulatory
February 2015 • Volume 19, Number 1 • Clinical Journal of Oncology Nursing
oncology infusion clinic affiliated with Dana-Farber Cancer Institute. Institutional review board approval was obtained prior to beginning the study procedures. Adult patients with a cancer diagnosis were recruited consecutively from the ambulatory infusion clinic during a three-month period. Eligible participants were at least 18 years of age and scheduled to start cycle one of a new chemotherapy regimen.
Procedure At this clinic, a standard of care is for all new patients starting chemotherapy to receive a nurse-led, prechemotherapy teaching session. The nurse provides the patient with information about treatment and expected symptoms, including detailed CINV education. During the teaching visit or at the first chemotherapy session, the clinic nurse approached each eligible patient about the study. Interested patients were provided details of the study by a nursing member of the study team, and written informed consent was obtained. After obtaining consent, the treating nurse completed a risk factor assessment checklist. The risk factor checklist assesses patient and treatment factors, such as chemotherapy regimen, emetogenicity of the regimen, gender, age, alcohol consumption, history of motion sickness
TABLE 1. Sample Characteristics (N = 30) Characteristic Age (years) Characteristic Gender Female Male Diagnosis Breast Lung Pancreatic Colorectal Othera Emetogenicity High Moderate Low Anticipatory CINV
Median
Range
56
29–85 n 24 7 10 7 5 4 4 11 15 4 15
Other diagnoses included leukemia, larynx cancer, and lymphoma. CINV—chemotherapy-induced nausea and vomiting a
or morning sickness, previous chemotherapy, and expectation or anticipation of CINV, that are associated with CINV based on current evidence (Pirri et al., 2011; Thompson, 2012). Risk factor assessment results were communicated to the treating clinician and incorporated into the electronic medical record. The treating clinician was able to document on the checklist any changes to the antiemetic regimen. A brief participant self-reported demographic form also was completed. A clinic nurse completed a structured telephone follow-up call to the participant at 24 and 72 hours (plus or minus 24–48 hours depending on day of the week) post-chemotherapy treatment, using the Multinational Association of Supportive Care in Cancer Antiemesis Tool (MAT) (Molassiotis et al., 2007) to assess acute and delayed CINV and to reinforce CINV treatment plans and education. The MAT measures both acute and delayed CINV. Responses included “yes” or “no” and assessed the number of times the symptom was experienced and the severity of the symptom on a scale from 0–10. Participants were also provided an opportunity to discuss any other questions or concerns during this follow-up. Each telephone call was documented in the electronic health record, and any pertinent symptom experience was communicated to the treating clinician through email and the electronic health record. A retrospective medical record review was completed after participants had completed study procedures, noting whether the telephone follow-up occurred and what was discussed. Descriptive measures of central tendency were calculated for all objectives.
Results Thirty-two consecutive, eligible patients were approached for study participation, and 30 consented. Table 1 describes the pertinent information about the study sample and as the emetogenicity of the treatment regimen. Of note, 15 participants reported anticipatory CINV on the risk factor checklist. Table 2 presents results for the primary and secondary objectives. The majority of participants completed the risk factor checklist and received both nurse telephone follow-up calls. In about half of the participants, clinicians changed
Clinical Journal of Oncology Nursing • Volume 19, Number 1 • Evidence-Based Practice
TABLE 2. Results of Primary and Secondary Study Outcomes (N = 30) Characteristic Primary outcomes Risk factor checklists completed Two nurse calls completed Secondary outcomes Reports of nausea at 24-hour call Reports of nausea at 48-hour call Reports of vomiting at 24-hour call Reports of vomiting at 48-hour call Changes made to antiemetic regimen
n 26 29 24 11 3 2 14
the standard antiemetic regimen based on the risk factor checklist information. The time to complete the telephone calls ranged from 5–10 minutes. Frequencies of CINV reports diminished from 24–72 hours post-treatment. In five instances, a participant reported a symptom other than CINV that required clinician followup and intervention.
Discussion A structured, nurse-led assessment and telephone follow-up intervention was successfully implemented in 30 participants receiving chemotherapy within an ambulatory oncology practice. The MAT and the follow-up telephone calls were completed in a reasonable and feasible amount of time. The majority of participants experienced nausea, particularly during the first 24 hours, indicating that this may be the most important time frame in which to reach out to patients in the future. The authors were able to identify symptoms requiring intervention in addition to CINV and promote treatment change for patients experiencing or anticipating CINV through structured assessment and follow-up. The next steps include implementing the intervention as the standard of care by assessing all patients for CINV risk and following up with all patients via a telephone call to provide additional support. The follow-up telephone calls will specifically be targeted to the 24-hour time period when participants reported the most symptoms of CINV.
Limitations The authors’ study findings cannot be generalized outside of a community 39
ambulatory oncology clinic in which nurses have set aside time for pretreatment teaching sessions. The high rate of enrollment and CINV results may not be generalized beyond a sample or population dominated by middle-aged adult women.
Conclusion Structured, nurse-led assessment and telephone follow-up was a feasible way to support patients experiencing cancer symptoms, including CINV. Assessment and structured telephone follow-up was completed in a timely manner and was useful for patients to report symptom experiences outside of the clinic. Future work should aim to evaluate the patientand system-level impact of implementing the assessment and follow-up procedure in multiple sites and to assess longer term results. The authors gratefully acknowledge the participants who volunteered their time to take part in this project, the nursing staff at the Dana-Farber/New Hampshire Oncology-Hematology clinic, and the physician colleagues who supported the project.
References Anderson, B. (2010). The benefits to nurseled telephone follow-up for prostate cancer. British Journal of Nursing, 19, 1085–1090. Aranda, S., Jefford, M., Yates, P., Gough, K., Seymour, J., Francis, P., . . . Schofield, P. (2012). Impact of a novel nurse-led prechemotherapy education intervention (ChemoEd) on patient distress, symptom burden, and treatment-related informa-
40
tion and support needs: Results from a randomised, controlled trial. Annals of Oncology, 23, 222–231. Craven, O., Hughes, C.A., Burton, A., Saunders, M.P., & Molassiotis, A. (2013). Is a nurse-led telephone intervention a viable alternative to nurse-led home care and standard care for patients receiving oral capecitabine? Results from a large prospective audit in patients with colorectal cancer. European Journal of Cancer Care, 22, 413–419. Cusack, M., & Taylor, C. (2010). A literature review of the potential of telephone follow-up in colorectal cancer. Journal of Clinical Nursing, 19, 2394–2405. Grunberg, S.M. (2012). Chemotherapyinduced nausea and vomiting incidence and prevalence. American Society of Clinical Oncology Educational Book, 2012, 541–543. Kimman, M.L., Dirksen, C.D., Voogd, A.C., Falger, P., Gijsen, B.C., Thuring, M., . . . Boersma, L.J. (2011). Nurse-led telephone follow-up and an educational group programme after breast cancer treatment: Results of a 2 × 2 randomised controlled trial. European Journal of Cancer, 47, 1027–1036. doi:10.1016/j.ejca.2010.12.003 Molassiotis, A., Aapro, M., Dicato, M., Gascon, P., Novoa, S.A., Isambert, N., . . . Roila, F. (2014). Evaluation of risk factors predicting chemotherapy-related nausea and vomiting: Results from a European prospective
observational study. Journal of Pain and Symptom Management, 47, 839–848. Molassiotis, A., Coventry, P.A., Stricker, C.T., Clements, C., Eaby, B., Velders, L., . . . Gralla, R.J. (2007). Validation and psychometric assessment of a short clinical scale to measure chemotherapy-induced nausea and vomiting: The MASCC Antiemesis Tool. Journal of Pain and Symptom Management, 34, 148–159. Pirri, C., Katris, P., Trotter, J., Bayliss, E., Bennett, R., & Drummond, P. (2011). Risk factors at pretreatment predicting treatment-induced nausea and vomiting in Australian cancer patients: A prospective, longitudinal, observational study. Supportive Care in Cancer, 19, 1549–1563. Roila, F., Herrstedt, J., Aapro, M., Gralla, R.J., Einhorn, L.H., Ballatori, E., . . . Warr, D. (2010). Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: Results of the Perugia consensus conference. Annals of Oncology, 21(Suppl. 5), v232–v243. Roscoe, J.A., Morrow, G.R., Aapro, M.S., Molassiotis, A., & Olver, I. (2011). Anticipatory nausea and vomiting. Supportive Care in Cancer, 19, 1533–1538. Thompson, N. (2012). Optimizing treatment outcomes in patients at risk for chemotherapy-induced nausea and vomiting. Clinical Journal of Oncology Nursing, 16, 309–313.
Do You Have an Interesting Topic to Share?
February 2015 • Volume 19, Number 1 • Clinical Journal of Oncology Nursing
Copyright of Clinical Journal of Oncology Nursing is the property of Oncology Nursing Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Carlton G. Brown, PhD, RN, AOCN®, FAAN—Associate Editor
A Nurse-Led Evidence-Based Practice Project to Monitor and Improve the Management of Chemotherapy-Induced Nausea and Vomiting Meghan L. Underhill, PhD, RN, AOCNS®, Lisa Chicko, RN, BA, OCN®, and Donna L. Berry, PhD, RN, AOCN®, FAAN
Chemotherapy-induced nausea and vomiting (CINV) is a common and severe symptom experienced by patients undergoing cancer treatment during the acute or delayed period. Individual characteristics can compound risk for CINV. Identification of risk factors for CINV and structured, nurse-led telephone follow-up are effective, evidence-based methods to support patients undergoing cancer treatment. The authors successfully implemented a structured, nurse-led CINV intervention to improve assessment, follow-up, and support for 30 patients undergoing chemotherapy within an adult ambulatory oncology clinic. At a Glance • CINV is a common and severe symptom for patients undergoing chemotherapy. • A nurse-led assessment and telephone follow-up intervention was able to successfully monitor patient-reported CINV during the acute and delayed periods. • A structured, nurse-led telephone intervention is a feasible way to allow patients to report symptoms outside of a clinical visit. Meghan L. Underhill, PhD, RN, AOCNS®, is a nurse scientist at the Phyllis F. Cantor Center for Research in Nursing and Patient Care Services at the Dana-Farber Cancer Institute in Boston, MA; Lisa Chicko, RN, BA, OCN®, is an infusion charge nurse at Dana-Farber/New Hampshire Oncology-Hematology in Londonderry; and Donna L. Berry, PhD, RN, AOCN®, FAAN, is an associate professor at the Phyllis F. Cantor Center for Research in Nursing and Patient Care Services at the Dana-Farber Cancer Institute. The authors take full responsibility for the content of the article. Funding for the work completed by M. Underhill was provided through the Phyllis F. Cantor Center. No financial relationships relevant to the content of this article have been disclosed by the editorial staff. Underhill can be reached at [email protected], with copy to editor at [email protected]. Key words: chemotherapy-induced nausea and vomiting; evidence-based practice; intervention Digital Object Identifier: 10.1188/15.CJON.38-40
C
hemotherapy-induced nausea and vomiting (CINV) are common and severe symptoms experienced by more than 50% of patients undergoing cancer treatment (Grunberg, 2012). CINV can occur in the acute period, defined as the initial 24 hours after treatment, or the delayed period, defined as 48–72 hours after treatment. Patients treated for cancer in ambulatory cancer settings will experience delayed CINV outside of the clinical setting where selfcare and medication self-administration are required to manage CINV. 38
Chemotherapy regimens are categorized based on level of emetogenicity (Roila et al., 2010), and typical antiemetic treatments are tailored based on mild-, moderate-, or high-level categories. In addition to the emetogenicity of the drug, certain personal characteristics place a patient at increased risk for CINV. These factors include female gender, aged 60 years or younger, minimal alcohol use, and past experiences with motion sickness, CINV, or chemotherapy (Pirri et al., 2011; Thompson, 2012). In addition, anticipatory CINV, or having an expecta-
tion that CINV will occur, is known to predispose a patient to CINV (Molassiotis et al., 2014; Roscoe, Morrow, Aapro, Molassiotis, & Olver, 2011). Treatments for CINV have improved with new medication regimens, but the symptom often may be underreported or undertreated when the patient is outside of the clinic during the acute or delayed symptom experience. Therefore, providing a mechanism for patients to receive support outside of the clinic appointment is important. Structured, nurse-led telephone follow-up and support, in addition to interdisciplinary management of symptoms, can improve patient-reported symptom outcomes (Anderson, 2010; Aranda et al., 2012; Craven, Hughes, Burton, Saunders, & Molassiotis, 2013; Cusack & Taylor, 2010; Kimman et al., 2011).
Study Objectives The primary study objective was to evaluate the process of implementing a structured, nurse-led assessment and telephone follow-up intervention. The authors describe participant enrollment, attrition and completion rates in the study, frequency of completion of nurse-led telephone follow-up, and time to complete the follow-up. A secondary objective was to evaluate the occurrence of acute and delayed CINV in the sample, describe the frequency of anticipatory CINV, and describe frequency of changes in antiemetic prescription after the nurse-led intervention.
Methods The current study included a descriptive, evidence-based practice project conducted at a community ambulatory
February 2015 • Volume 19, Number 1 • Clinical Journal of Oncology Nursing
oncology infusion clinic affiliated with Dana-Farber Cancer Institute. Institutional review board approval was obtained prior to beginning the study procedures. Adult patients with a cancer diagnosis were recruited consecutively from the ambulatory infusion clinic during a three-month period. Eligible participants were at least 18 years of age and scheduled to start cycle one of a new chemotherapy regimen.
Procedure At this clinic, a standard of care is for all new patients starting chemotherapy to receive a nurse-led, prechemotherapy teaching session. The nurse provides the patient with information about treatment and expected symptoms, including detailed CINV education. During the teaching visit or at the first chemotherapy session, the clinic nurse approached each eligible patient about the study. Interested patients were provided details of the study by a nursing member of the study team, and written informed consent was obtained. After obtaining consent, the treating nurse completed a risk factor assessment checklist. The risk factor checklist assesses patient and treatment factors, such as chemotherapy regimen, emetogenicity of the regimen, gender, age, alcohol consumption, history of motion sickness
TABLE 1. Sample Characteristics (N = 30) Characteristic Age (years) Characteristic Gender Female Male Diagnosis Breast Lung Pancreatic Colorectal Othera Emetogenicity High Moderate Low Anticipatory CINV
Median
Range
56
29–85 n 24 7 10 7 5 4 4 11 15 4 15
Other diagnoses included leukemia, larynx cancer, and lymphoma. CINV—chemotherapy-induced nausea and vomiting a
or morning sickness, previous chemotherapy, and expectation or anticipation of CINV, that are associated with CINV based on current evidence (Pirri et al., 2011; Thompson, 2012). Risk factor assessment results were communicated to the treating clinician and incorporated into the electronic medical record. The treating clinician was able to document on the checklist any changes to the antiemetic regimen. A brief participant self-reported demographic form also was completed. A clinic nurse completed a structured telephone follow-up call to the participant at 24 and 72 hours (plus or minus 24–48 hours depending on day of the week) post-chemotherapy treatment, using the Multinational Association of Supportive Care in Cancer Antiemesis Tool (MAT) (Molassiotis et al., 2007) to assess acute and delayed CINV and to reinforce CINV treatment plans and education. The MAT measures both acute and delayed CINV. Responses included “yes” or “no” and assessed the number of times the symptom was experienced and the severity of the symptom on a scale from 0–10. Participants were also provided an opportunity to discuss any other questions or concerns during this follow-up. Each telephone call was documented in the electronic health record, and any pertinent symptom experience was communicated to the treating clinician through email and the electronic health record. A retrospective medical record review was completed after participants had completed study procedures, noting whether the telephone follow-up occurred and what was discussed. Descriptive measures of central tendency were calculated for all objectives.
Results Thirty-two consecutive, eligible patients were approached for study participation, and 30 consented. Table 1 describes the pertinent information about the study sample and as the emetogenicity of the treatment regimen. Of note, 15 participants reported anticipatory CINV on the risk factor checklist. Table 2 presents results for the primary and secondary objectives. The majority of participants completed the risk factor checklist and received both nurse telephone follow-up calls. In about half of the participants, clinicians changed
Clinical Journal of Oncology Nursing • Volume 19, Number 1 • Evidence-Based Practice
TABLE 2. Results of Primary and Secondary Study Outcomes (N = 30) Characteristic Primary outcomes Risk factor checklists completed Two nurse calls completed Secondary outcomes Reports of nausea at 24-hour call Reports of nausea at 48-hour call Reports of vomiting at 24-hour call Reports of vomiting at 48-hour call Changes made to antiemetic regimen
n 26 29 24 11 3 2 14
the standard antiemetic regimen based on the risk factor checklist information. The time to complete the telephone calls ranged from 5–10 minutes. Frequencies of CINV reports diminished from 24–72 hours post-treatment. In five instances, a participant reported a symptom other than CINV that required clinician followup and intervention.
Discussion A structured, nurse-led assessment and telephone follow-up intervention was successfully implemented in 30 participants receiving chemotherapy within an ambulatory oncology practice. The MAT and the follow-up telephone calls were completed in a reasonable and feasible amount of time. The majority of participants experienced nausea, particularly during the first 24 hours, indicating that this may be the most important time frame in which to reach out to patients in the future. The authors were able to identify symptoms requiring intervention in addition to CINV and promote treatment change for patients experiencing or anticipating CINV through structured assessment and follow-up. The next steps include implementing the intervention as the standard of care by assessing all patients for CINV risk and following up with all patients via a telephone call to provide additional support. The follow-up telephone calls will specifically be targeted to the 24-hour time period when participants reported the most symptoms of CINV.
Limitations The authors’ study findings cannot be generalized outside of a community 39
ambulatory oncology clinic in which nurses have set aside time for pretreatment teaching sessions. The high rate of enrollment and CINV results may not be generalized beyond a sample or population dominated by middle-aged adult women.
Conclusion Structured, nurse-led assessment and telephone follow-up was a feasible way to support patients experiencing cancer symptoms, including CINV. Assessment and structured telephone follow-up was completed in a timely manner and was useful for patients to report symptom experiences outside of the clinic. Future work should aim to evaluate the patientand system-level impact of implementing the assessment and follow-up procedure in multiple sites and to assess longer term results. The authors gratefully acknowledge the participants who volunteered their time to take part in this project, the nursing staff at the Dana-Farber/New Hampshire Oncology-Hematology clinic, and the physician colleagues who supported the project.
References Anderson, B. (2010). The benefits to nurseled telephone follow-up for prostate cancer. British Journal of Nursing, 19, 1085–1090. Aranda, S., Jefford, M., Yates, P., Gough, K., Seymour, J., Francis, P., . . . Schofield, P. (2012). Impact of a novel nurse-led prechemotherapy education intervention (ChemoEd) on patient distress, symptom burden, and treatment-related informa-
40
tion and support needs: Results from a randomised, controlled trial. Annals of Oncology, 23, 222–231. Craven, O., Hughes, C.A., Burton, A., Saunders, M.P., & Molassiotis, A. (2013). Is a nurse-led telephone intervention a viable alternative to nurse-led home care and standard care for patients receiving oral capecitabine? Results from a large prospective audit in patients with colorectal cancer. European Journal of Cancer Care, 22, 413–419. Cusack, M., & Taylor, C. (2010). A literature review of the potential of telephone follow-up in colorectal cancer. Journal of Clinical Nursing, 19, 2394–2405. Grunberg, S.M. (2012). Chemotherapyinduced nausea and vomiting incidence and prevalence. American Society of Clinical Oncology Educational Book, 2012, 541–543. Kimman, M.L., Dirksen, C.D., Voogd, A.C., Falger, P., Gijsen, B.C., Thuring, M., . . . Boersma, L.J. (2011). Nurse-led telephone follow-up and an educational group programme after breast cancer treatment: Results of a 2 × 2 randomised controlled trial. European Journal of Cancer, 47, 1027–1036. doi:10.1016/j.ejca.2010.12.003 Molassiotis, A., Aapro, M., Dicato, M., Gascon, P., Novoa, S.A., Isambert, N., . . . Roila, F. (2014). Evaluation of risk factors predicting chemotherapy-related nausea and vomiting: Results from a European prospective
observational study. Journal of Pain and Symptom Management, 47, 839–848. Molassiotis, A., Coventry, P.A., Stricker, C.T., Clements, C., Eaby, B., Velders, L., . . . Gralla, R.J. (2007). Validation and psychometric assessment of a short clinical scale to measure chemotherapy-induced nausea and vomiting: The MASCC Antiemesis Tool. Journal of Pain and Symptom Management, 34, 148–159. Pirri, C., Katris, P., Trotter, J., Bayliss, E., Bennett, R., & Drummond, P. (2011). Risk factors at pretreatment predicting treatment-induced nausea and vomiting in Australian cancer patients: A prospective, longitudinal, observational study. Supportive Care in Cancer, 19, 1549–1563. Roila, F., Herrstedt, J., Aapro, M., Gralla, R.J., Einhorn, L.H., Ballatori, E., . . . Warr, D. (2010). Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: Results of the Perugia consensus conference. Annals of Oncology, 21(Suppl. 5), v232–v243. Roscoe, J.A., Morrow, G.R., Aapro, M.S., Molassiotis, A., & Olver, I. (2011). Anticipatory nausea and vomiting. Supportive Care in Cancer, 19, 1533–1538. Thompson, N. (2012). Optimizing treatment outcomes in patients at risk for chemotherapy-induced nausea and vomiting. Clinical Journal of Oncology Nursing, 16, 309–313.
Do You Have an Interesting Topic to Share?
February 2015 • Volume 19, Number 1 • Clinical Journal of Oncology Nursing
Copyright of Clinical Journal of Oncology Nursing is the property of Oncology Nursing Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
