Anticipatory nausea and vomiting occurred in 25 percent of 568 consecutive chemotherapy outpatients previously studied for anticipatory side effects. Converging lines of evidence from psychologic, pharmacologic and neurologic investigations support the view that anticipatory nausea/vomiting is a learned or conditioned bahavior. Systematic Desensitization has been established experimentally as both a precise and effective treatment for maladaptive learned behaviors. A randomized clinical trial showed the antiemetic effectiveness of Systematic Desensitization when administered by an experienced behavioral psychologist for the control of anticiapatory nausea/vomiting (ANV). Research proposed in this continuation application systematically expands previous promising findings through two specific studies: The first investigates through a randomized comparative clinical trial, the degree to which Systematic Desensitization is effective when used by oncology clinical personnel for control of patients' ANV. The second tests the ability of a 7 question clinical profile to predict which chemotherapy patients will develop anticipatory side effects. Over 300 new patients a year enter chemotherapy research trials at the University of Rochester Cancer Research Center. All will be screened with the predictive clinical profile at their second treatment cycle. Anticipatory nausea/vomiting and other criteria for entry into the clinical trial will be assessed at the fourth cycle. A sample size of 90 patients randomized to two experimental and one control arm of the clinical trial will assure conventionally assumed levels of protection for type 1 (Alpha = .05) and type 2 (power = 0.80) experimental errors. The proposed study has the anticipated long-term benefit of improving patient compliance in both best current treatment (Phase IV) and randomized (Phase III) treatment research trials.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
9R01NR001905-07
Application #
3391776
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1979-09-30
Project End
1992-09-29
Budget Start
1987-09-30
Budget End
1988-09-29
Support Year
7
Fiscal Year
1987
Total Cost
Indirect Cost
Name
University of Rochester
Department
Type
School of Medicine & Dentistry
DUNS #
208469486
City
Rochester
State
NY
Country
United States
Zip Code
14627
Morrow, Gary R; Hickok, Jane T; Andrews, Paul L R et al. (2002) Reduction in serum cortisol after platinum based chemotherapy for cancer: a role for the HPA axis in treatment-related nausea? Psychophysiology 39:491-5
Hickok, J T; Roscoe, J A; Morrow, G R (2001) The role of patients' expectations in the development of anticipatory nausea related to chemotherapy for cancer. J Pain Symptom Manage 22:843-50
Roscoe, J A; Morrow, G R; Hickok, J T et al. (2000) Nausea and vomiting remain a significant clinical problem: trends over time in controlling chemotherapy-induced nausea and vomiting in 1413 patients treated in community clinical practices. J Pain Symptom Manage 20:113-21
Nair, M G; Hickok, J T; Roscoe, J A et al. (2000) Sources of information used by patients to learn about chemotherapy side effects. J Cancer Educ 15:19-22
Roscoe, J A; Hickok, J T; Morrow, G R (2000) Patient expectations as predictor of chemotherapy-induced nausea. Ann Behav Med 22:121-6
Morrow, G R; Andrews, P L; Hickok, J T et al. (2000) Vagal changes following cancer chemotherapy: implications for the development of nausea. Psychophysiology 37:378-84
Morrow, G R; Hickok, J T; DuBeshter, B et al. (1999) Changes in clinical measures of autonomic nervous system function related to cancer chemotherapy-induced nausea. J Auton Nerv Syst 78:57-63
Hickok, J T; Roscoe, J A; Morrow, G R et al. (1999) Use of 5-HT3 receptor antagonists to prevent nausea and emesis caused by chemotherapy for patients with breast carcinoma in community practice settings. Cancer 86:64-71
Morrow, G R; Roscoe, J A; Hickok, J T et al. (1998) Initial control of chemotherapy-induced nausea and vomiting in patient quality of life. Oncology (Williston Park) 12:32-7
Morrow, G R; Hickok, J T; Burish, T G et al. (1996) Frequency and clinical implications of delayed nausea and delayed emesis. Am J Clin Oncol 19:199-203

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