Non-pharmacological interventions for chemotherapy-induced diarrhoea and constipation management: A scoping review

Thi Hanh Phung; Erin Pitt; Kimberly Alexander; Natalie Bradford

doi:10.1016/j.ejon.2023.102485

Non-pharmacological interventions for chemotherapy-induced diarrhoea and constipation management: A scoping review

Eur J Oncol Nurs. 2024 Feb:68:102485. doi: 10.1016/j.ejon.2023.102485. Epub 2023 Dec 9.

Authors

Thi Hanh Phung¹, Erin Pitt², Kimberly Alexander³, Natalie Bradford³

Affiliations

¹ School of Nursing, Faculty of Health, N block, Queensland University of Technology, Kelvin Grove, 4059, Australia; Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Viet Nam. Electronic address: thihanh.phung@hdr.qut.edu.au.
² School of Nursing, Faculty of Health, N block, Queensland University of Technology, Kelvin Grove, 4059, Australia; Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, Queensland University of Technology, X block, 66 Musk Avenue, Kelvin Grove, 4059, Australia; Cancer Nurses Society of Australia, 165 Sovereign Hill Drive, Gabbadah, Western Australia, 6041, Australia.
³ School of Nursing, Faculty of Health, N block, Queensland University of Technology, Kelvin Grove, 4059, Australia; Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, Queensland University of Technology, X block, 66 Musk Avenue, Kelvin Grove, 4059, Australia; Cancer Nurses Society of Australia, 165 Sovereign Hill Drive, Gabbadah, Western Australia, 6041, Australia; Centre for Children's Health Research, Children's Health Queensland Hospital and Health Services, South Brisbane, 4101, Australia.

PMID: 38104513
DOI: 10.1016/j.ejon.2023.102485

Abstract

Purpose: Chemotherapy-induced diarrhoea (CID) and constipation (CIC) are among the most common and severe gastrointestinal symptoms related to chemotherapy. This review aimed to identify and describe the evidence for non-pharmacological interventions for the management of CID and CIC.

Methods: The scoping review was based on the Joanna Briggs Institute methodology and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Evidence from five databases were included: CINAHL, MEDLINE, Embase, PubMed, and APA PsycInfo. Data were systematically identified, screened, extracted and synthesised narratively to describe the evidence for non-pharmacological interventions and their effects on CID and CIC.

Results: We included 33 studies, of which 18 investigated non-pharmacological interventions for CID management, six for CIC management, and nine for both CID and CIC management. Interventions were categorized into five groups, including (1) digital health interventions, (2) physical therapies, (3) diet and nutrition therapies, (4) education, and (5) multimodal. Diet and nutrition therapies were the most common to report potential effectiveness for CID and CIC outcomes. Most of the interventions were implemented in hospitals under the supervision of healthcare professionals and were investigated in randomised control trials.

Conclusions: The characteristics of non-pharmacological interventions were diverse, and the outcomes were inconsistent among the same type of interventions. Diet and nutritional interventions show promise but further research is needed to better understand their role and to contribute to the evidence base. Nurses are well placed to assess and monitor for CIC and CID, and also deliver effective non-pharmacological interventions.

Keywords: Chemotherapy; Chemotherapy-induced constipation; Chemotherapy-induced diarrhoea; Complementary and alternative medicine; Non-pharmacological interventions; Self-care; Self-management.

Publication types

Systematic Review
Review

MeSH terms

Constipation* / chemically induced
Constipation* / therapy
Diarrhea / chemically induced
Diarrhea / therapy
Diet*
Health Personnel
Humans