Does assessing patients' expectancies about chemotherapy side effects influence their occurrence?

J Pain Symptom Manage. 2013 Aug;46(2):275-81. doi: 10.1016/j.jpainsymman.2012.07.013. Epub 2012 Nov 11.

Abstract

Context: Increasing evidence suggests a link between patients' expectancies and post-chemotherapy side effects. However, it remains unclear whether asking patients about their expectancies might actually increase side effects.

Objectives: The present study tested whether questioning first-time chemotherapy patients about their pretreatment expectancies for four common side effects influences the occurrence and/or severity of these side effects post-treatment and whether these pretreatment expectancies are predictive of post-treatment side effects.

Methods: Ninety-one first-time chemotherapy patients were randomly allocated to have their expectancies for nausea, fatigue, feelings of sadness, and loss of appetite assessed before their first infusion or to no such assessment. All patients then rated the occurrence and severity of these side effects at the end of their first chemotherapy cycle.

Results: 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. There was, however, evidence of a statistically significant positive relationship between patients' pretreatment expectancies and their post-treatment reports of nausea, loss of appetite, and feelings of sadness, after controlling for age, sex, and baseline symptom levels.

Conclusion: These findings suggest that patient expectancies might be a useful point of intervention for attempting to reduce the burden of 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 occurrence of post-treatment side effects.

Keywords: Chemotherapy; appetite; cancer; depression; expectancy; fatigue; nausea; placebo effect; side effects.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticipation, Psychological
  • Antineoplastic Agents / therapeutic use*
  • Attitude to Health
  • Awareness
  • Comorbidity
  • Drug Therapy / psychology*
  • Drug Therapy / statistics & numerical data*
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Drug-Related Side Effects and Adverse Reactions / psychology*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Neoplasms / epidemiology
  • Neoplasms / psychology*
  • New South Wales / epidemiology
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Quality of Life
  • Risk Factors
  • Surveys and Questionnaires

Substances

  • Antineoplastic Agents