A Randomized Clinical Trial Investigating an Integrated Nursing Educational Program to Mitigate Chemotherapy-Induced Nausea and Vomiting in Cancer Patients: The NIV-EC Trial

SIMPLE SUMMARY: Chemotherapy-induced nausea and vomiting is a prevalent and distressing side effect of chemotherapy, greatly impacting patient quality of life. In addition to pharmacological prevention, nausea and vomiting can be mitigated through patient education on their prevention and management, especially when supporting material is provided. The present randomized controlled trial evaluated the use of an informative booklet with details on antiemetic drugs and nutritional recommendations to reduce CINV provided to patients in addition to oral information. Cancer patients undergoing first chemotherapy cycle were randomly assigned to receive oral information regarding CINV prevention and management (control arm) or oral information plus an informative booklet (experimental arm). Patients in the experimental arm reported a lower frequency of nausea occurrence in the first five days after chemotherapy by about 8%, compared to those in the control group. Although the beneficial effect was moderate, this intervention demands minimal resources in terms of costs and time. ABSTRACT: Background: In addition to pharmacological prevention, chemotherapy-induced nausea and vomiting (CINV) can be mitigated through patient education; written supporting materials can be beneficial. Methods: This is a randomized, controlled trial which randomly assigned patients undergoing first chemotherapy cycle to receive oral information regarding CINV prevention and management (control arm) or oral information plus an informative booklet (experimental arm). Overall, 384 cancer patients fulfilling the following inclusion criteria were enrolled: age ≥18 years; life expectancy ≥6 months; no cognitive impairment; written informed consent. After the first cycle, CINV occurrence and its impact on daily activities were assessed using the Functional Living Index Emesis (FLIE). Results: Severe nausea was self-reported by 3.0% and 10.8% of patients in the experimental and control group, respectively (difference: 7.8%; 95% confidence interval: 2.3% to 13.1%). Moderate/high impact of nausea on daily activities was lower in patients also receiving the booklet than in the control group (4.2% and 10.1%, respectively; difference: 5.9%; 95% confidence interval: 0.3% to 11.5%). Vomiting was not statistically different between study arms. Conclusions: This integrated nursing approach was effective in aiding cancer patients in CINV self-management. Although the beneficial effect was moderate, this intervention demands minimal resources in terms of costs and time.