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An assessment of aetiology-based guidelines for the management of nausea and vomiting in patients with advanced cancer

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Abstract

Study aim

The aim of this study was to assess the effectiveness of aetiology-based guidelines for the management of nausea and vomiting (N&V) in patients with advanced cancer.

Patients and methods

This was a prospective study of 121 patients admitted to a hospice. Patients with N&V underwent assessments at presentation, 48 h and 1 week, to determine the aetiology of N&V and the response to treatment. Antiemetics were prescribed according to aetiology-based guidelines.

Results

Sixty-one patients (50%) had N&V during their admission: 21 (17%) had isolated nausea, 2 (2%) had isolated vomiting and 38 (31%) had combined N&V. During the assessment period, physicians altered their opinion about the primary cause of N&V in 26% of cases and finally expressed confidence about the aetiology in 75% of patients. The most common cause of N&V was impaired gastric emptying (contributing in 44% of patients), followed by chemical causes (33%) and bowel obstruction (19%). At 1 week, nausea was controlled in 56% of patients, and vomiting in 89% of patients, and residual symptoms were generally mild.

Conclusions

An approach using aetiology-based guidelines in the management of N&V is moderately effective, although there are some patients with N&V refractory to standard antiemetic regimens.

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Acknowledgements

We should like to thank the medical and nursing staff at St. Luke’s Hospice for their support and participation in the data collection. We should also like to thank Professor Geoff Hanks for his comments on the study design/study protocol.

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Authors and Affiliations

  1. St. Luke’s Hospice, Stamford Road, Turnchapel, Plymouth, PL9 9XA, UK

    Jeffrey Stephenson

  2. Royal Marsden Hospital, Sutton, UK

    Andrew Davies

Authors
  1. Jeffrey Stephenson
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  2. Andrew Davies
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Corresponding author

Correspondence to Jeffrey Stephenson.

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Stephenson, J., Davies, A. An assessment of aetiology-based guidelines for the management of nausea and vomiting in patients with advanced cancer. Support Care Cancer 14, 348–353 (2006). https://doi.org/10.1007/s00520-005-0897-1

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  • DOI: https://doi.org/10.1007/s00520-005-0897-1

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