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Vomiting-Free Ward Improves CINV, QOL In Patients With Gynecologic Cancer

Implementing a vomit-free ward initiative improved the quality of life (QOL) and decreased anxiety and depression among gynecologic oncology patients receiving chemotherapy, according to the results of a study in Supportive Care in Cancer. 

Researchers set out to evaluate the impact of a vomiting-free ward initiative for managing chemotherapy-induced nausea and vomiting (CINV) in gynecologic oncology patients, as well as its effects on their psychological well-being and QOL. 

A total of 960 patients who were receiving inpatient chemotherapy for a gynecologic cancer at a hospital in Sichuan Province in China were enrolled from January to December 2023. The patients were evenly assigned to a control group or an intervention group based on their admission dates. The patients in the control group underwent standard care, whereas those in the intervention group received standard care along with a vomiting-free ward protocol. 

Establishing this type of specialized ward entailed forming a multidisciplinary team, training personnel, improving the admission and assessment processes, incorporating psychological assessments and interventions, and standardizing antiemetic medication protocols. It also entailed making sure that patients were diligently monitored and given the opportunity for telemedicine follow-ups.

The researchers evaluated the effectiveness of the specialized ward with the following tools: the Multinational Association of Supportive Care in Cancer (MASCC) Antiemesis Tool, the Functional Living Index-Emesis (FLIE), and the Hospital Anxiety and Depression Scale (HADS).

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The results indicate that the inauguration of this specialized ward significantly reduces the incidence of both acute and delayed CINV, lowers patients' anxiety and depression levels, and improves their QOL, in relation to CINV.

The intervention group experienced significant improvement in both severity and frequency of acute and delayed CINV compared to the control group. The impact of severe nausea and vomiting on leisure activities was reduced by 9.7% and 7.2%, and the effect of moderate to severe nausea and vomiting on patients' daily lives was reduced by 6.9% and 8.6%, respectively. 

Also, the vomiting-free ward implementation resulted in significant reductions in patient anxiety (t, −3.148; P <.001) and depression (t, −3.223; P <.001). 

"The results indicate that the inauguration of this specialized ward significantly reduces the incidence of both acute and delayed CINV, lowers patients' anxiety and depression levels, and improves their QOL, in relation to CINV," the research team wrote in conclusion. "The implementation of the vomiting-free ward in this study provides important insights for the future prevention and management of CINV."

Disclosures: This study was supported by the Science and Technology Project of the Health Planning Committee of Sichuan and the Nursing Department at West China Second University Hospital, Sichuan University. Please see the original reference for a full list of disclosures. 

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