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Published on: June 21, 2024
Incidence and Risk Factors of Chemotherapy-Induced Nausea and Vomiting Among Adult Cancer Patients at Mbarara
Patrick Kitheka Muasya1,2, Tadele Mekuriya Yadesa1,3, John Isiiko1,4
1Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara City, Uganda.
Background:
Chemotherapy-induced nausea and vomiting (CINV) remains a significant and distressing adverse effect of cancer treatment, adversely affecting patients' quality of life. Despite well-established international guidelines for antiemetic prophylaxis, variability in CINV incidence and guideline adherence persists across different regions and healthcare settings, particularly in low- and middle-income countries (LMICs).
Objective:
This study determined the incidence and associated factors of chemotherapy-induced nausea and vomiting (CINV) among adult cancer patients at Mbarara Regional Referral Hospital.
Methods:
A prospective observational study was conducted among 237 adult cancer patients receiving chemotherapy at the Mbarara Regional Referral Hospital. The MASCC Antiemesis Tool (MAT) was used to assess acute nausea and vomiting (≤24 hours) and delayed nausea and vomiting (>24 hours to 5 days), as well as any chemotherapy-induced nausea and vomiting (CINV; nausea and/or vomiting). A 5-day follow-up using the MAT tool for acute (≤24hours) and delayed (>24hours-5 days) CINV was conducted.
Results:
Among 237 participants, 66 (27.8%) and 136 (57.4%) experienced acute and delayed nausea, and 53 (22.4%) and 101 (42.6%) experienced acute and delayed vomiting; 67 (28.3%) and 136 (57.4%) had combined acute and delayed nausea and vomiting. Antiemetic prophylaxis guideline adherence was 73.4%, with 26.6% receiving non-guideline-compliant regimens. Independent associated factors for CINV were female sex (AOR = 2.0, 95% CI: 1.1-3.8; p = 0.026), moderate- (AOR = 21.2, 95% CI: 9.1-49.0; p < 0.001) and high-emetogenic chemotherapy (AOR = 22.6, 95% CI: 8.6-59.2; p < 0.001), and prior CINV (AOR = 6.1, 95% CI: 2.8-12.9; p < 0.001).
Conclusion:
Over half of the participants experienced delayed chemotherapy-induced nausea and vomiting, while nearly one-third experienced acute CINV. Adherence to guidelines for antiemetic prophylaxis was high at 73.4%. Key identified associated factors included female gender, moderate to highly emetogenic potential of chemotherapy regimens, and a history of CINV in this study population.
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