A Systematic Literature Review of Interventions to Manage Hiccups in Patients With Cancer Undergoing Active Treatment.

Abstract

Background: Patients with cancer often experience persistent or intractable hiccups, which negatively impact their quality of life. Yet, interventions aimed at managing hiccups among patients with cancer receiving active treatment are lacking.

Objective: To describe existing evidence on interventions that address hiccup management in patients with cancer receiving active treatment with curative intent.

Methods: Our narrative synthesis review was conducted through a systematic search of 3 electronic databases (CINAHL Complete, PubMed, and HOLLIS) augmented by hand search from January 2003 to July 2023 to retrieve peer-reviewed articles published in English. Our review was guided by PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) and registered through the National Institute for Health Research, International Prospective Register of Systematic Reviews (CRD42023444545).

Results: The database searches yielded 2686 records. After removing duplicates and ineligible articles, 13 articles met the inclusion criteria. Most were noninterventional observational studies. The most common pharmacologic interventions were as follows: steroid rotation (replacing dexamethasone with methylprednisolone or omitting dexamethasone), baclofen, and olanzapine. Of these pharmacologic interventions, replacing dexamethasone with another antiemetic was most beneficial in reducing hiccups. Baclofen was also found to be beneficial in reducing chronic or intractable hiccups. Acupuncture was found to be an effective nonpharmacologic intervention.

Conclusions: This review identified several promising interventions such as steroid rotation (replacing dexamethasone with methylprednisolone or omitting dexamethasone), baclofen, and acupuncture for hiccup management among patients with cancer undergoing active treatment.

Implications for practice: Future studies to identify efficacious interventions for hiccups among patients with cancer receiving active treatment are warranted.