The Benefit of Pro Re Nata Antiemetics Provided With Guideline-Consistent Antiemetics in Delayed Nausea Control

Abstract

BACKGROUND: Delayed nausea after chemotherapy remains a symptom of interest. Clinicians often provide additional and/or pro re nata (p.r.n.) antiemetics with guideline-consistent antiemetics in an attempt to achieve further symptom control. Whether the usage of additional and/or p.r.n. antiemetics provide added benefit remains as a question. OBJECTIVE: The purpose of this study was to determine the benefit of providing additional antiemetics and/or p.r.n. antiemetics with guideline-consistent antiemetics in the control of nausea, functioning, and quality of life (QOL). METHODS: A secondary data analysis of 143 breast cancer patients who received guideline-consistent antiemetics for anthracycline and cyclophosphamide chemotherapy was conducted. Instruments included vomiting frequency and nausea intensity items of the Multinational Association of Supportive Care in Cancer Antiemesis Tool and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30. RESULTS: Providing p.r.n. antiemetics alleviated the incidence of significant nausea (intensity, >/=3) in the delayed phase. The experience of nausea contributed to symptom incidence in the next phase and cycle. The intensity of delayed nausea demonstrated a moderate negative correlation with physical and role functioning and global health/QOL. CONCLUSION: Providing patients with strategies to further control nausea (p.r.n. antiemetics) in addition to guideline-consistent antiemetics is recommended for practice. Because the nausea experience contributes to symptom incidence in the next phase and cycle and because the nausea intensity demonstrated a significant relationship with function and global health/QOL, proactive supportive approaches are strongly recommended. IMPLICATIONS FOR PRACTICE: Delayed nausea control may be improved by adhering to guideline-consistent antiemetics and using p.r.n. antiemetics. Delayed nausea control would contribute to patients' functioning and QOL.