Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study

Alison Pearce; Marion Haas; Rosalie Viney; Sallie-Anne Pearson; Philip Haywood; Chris Brown; Robyn Ward

doi:10.1371/journal.pone.0184360

Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study

PLoS One. 2017 Oct 10;12(10):e0184360. doi: 10.1371/journal.pone.0184360. eCollection 2017.

Authors

Alison Pearce¹, Marion Haas¹, Rosalie Viney¹, Sallie-Anne Pearson², Philip Haywood¹, Chris Brown³, Robyn Ward^{4

5}

Affiliations

¹ Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia.
² Medicines Policy Research Unit, University of New South Wales, Sydney, New South Wales, Australia.
³ NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
⁴ Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
⁵ University of Queensland, Brisbane, Queensland, Australia.

Abstract

Aim: Chemotherapy side effects are often reported in clinical trials; however, there is little evidence about their incidence in routine clinical care. The objective of this study was to describe the frequency and severity of patient-reported chemotherapy side effects in routine care across treatment centres in Australia.

Methods: We conducted a prospective cohort study of individuals with breast, lung or colorectal cancer undergoing chemotherapy. Side effects were identified by patient self-report. The frequency, prevalence and incidence rates of side effects were calculated by cancer type and grade, and cumulative incidence curves for each side effect computed. Frequencies of side effects were compared between demographic subgroups using chi-squared statistics.

Results: Side effect data were available for 449 eligible individuals, who had a median follow-up of 5.64 months. 86% of participants reported at least one side effect during the study period and 27% reported a grade IV side effect, most commonly fatigue or dyspnoea. Fatigue was the most common side effect overall (85%), followed by diarrhoea (74%) and constipation (74%). Prevalence and incidence rates were similar across side effects and cancer types. Age was the only demographic factor associated with the incidence of side effects, with older people less likely to report side effects.

Conclusion: This research has produced the first Australian estimates of self-reported incidence of chemotherapy side effects in routine clinical care. Chemotherapy side effects in routine care are common, continue throughout chemotherapy and can be serious. This work confirms the importance of observational data in providing clinical practice-relevant information to decision-makers.

MeSH terms

Adult
Aged
Australia
Breast Neoplasms / drug therapy
Breast Neoplasms / epidemiology*
Breast Neoplasms / pathology
Colorectal Neoplasms / drug therapy
Colorectal Neoplasms / epidemiology*
Colorectal Neoplasms / pathology
Drug-Related Side Effects and Adverse Reactions / epidemiology*
Drug-Related Side Effects and Adverse Reactions / pathology
Female
Humans
Lung Neoplasms / drug therapy
Lung Neoplasms / epidemiology*
Lung Neoplasms / pathology
Male
Middle Aged
Neoplasm Staging
Self Report
Surveys and Questionnaires

Grants and funding

The Elements of Cancer Care study was funded by the National Health and Medical Research Council (Health Services Research Grant ID 455366). AP was supported by a University of Technology Sydney Doctoral Scholarship, and a PhD top-up scholarship from NHMRC Health Services Research Grant (ID455366). SP is supported by a Cancer Institute NSW Career Development Fellowship (ID: 12/CDF/2-25). No funding organisation had any role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.