Oral Presentation COSA-IPOS Joint Scientific Meeting 2012

Does assessing patients’ expectancies about chemotherapy side effect influence their occurrence? (#262)

Ben Colagiuri 1 , Haryana Dhillon 2 , Phyllis N Butow 2 , Jesse Jansen 3 , Keith Cox 4 , Jaralyn Jacquet 5
  1. School of Psychology, University of Sydney, Sydney, NSW, Australia
  2. Centre for Medical Psychology and Evidenced-based Decision Making, University of Sydney, Sydney, NSW, Australia
  3. Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, NSW, Australia
  4. Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia
  5. Sydney Cancer Centre, Concord Repatriation Hospital, Sydney, NSW, Australia

Aim: Mounting evidence indicates a link between patients’ pre-chemotherapy expectancies and their subsequent experience of side effects. However, it remains unclear whether questioning patients about their expectancies could actually increase their side effects in and of itself. The current study tested whether questioning first-time chemotherapy patients about their pretreatment expectancies for four common side effects influenced the occurrence and/or severity of these side effects posttreatment.
Methods: Ninety-one (81% response rate) mixed cancer patients undergoing chemotherapy for the first time were randomly allocated to have their expectancies for nausea, fatigue, feelings of sadness, and loss of appetite assessed prior to their first treatment or to no expectancy assessment. All patients then rated the occurrence and severity of these side effects at the end of their first chemotherapy cycle on both study-specific and established questionnaires (QLQ-C30).
Results: In terms of overall side effect occurrence, 75% reported nausea, 78% reported fatigue, 58% reported loss in appetite, and 44% reported feelings of sadness during their first cycle. There were no statistically significant differences in occurrence or severity of side effects in those who had their expectancies assessed compared with those who did not (all p>.05). There was, however, evidence of a significant positive relationship between patients’ pretreatment expectancies and their posttreatment reports of nausea (severity: β=.34, p=.04), loss of appetite (occurrence: OR=9.6, p=.05; severity: β=.38, p=.02), and feelings of sadness (occurrence: OR=4.4, p=.05; severity: β=.36, p=.009), after controlling for age, sex, and baseline symptom levels.
Conclusion: These findings indicate that patient expectancies might be a useful point of intervention for reducing the burden of some chemotherapy-related side effects, as there do not appear to be any detrimental effects of asking patients to report their expectancies and their expectancies do appear related to the experience of posttreatment side effects.