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Pilas SA, Kurt S. Evaluation of oral mucositis level and affecting factors in cancer patients receiving chemotherapy. Support Care Cancer 2024; 32:597. [PMID: 39162830 DOI: 10.1007/s00520-024-08812-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 08/14/2024] [Indexed: 08/21/2024]
Abstract
OBJECTIVES This study aimed to evaluate the severity of oral mucositis and the contributing factors among cancer patients undergoing chemotherapy. METHODS This study was planned cross-sectional. The study was conducted at a medical oncology clinic between January and July 2022. The sample consisted of 245 patients with cancer receiving chemotherapy. Data were collected using a personal, oral health and disease-related characteristics questionnaire and the World Health Organization Oral Mucositis Assessment Scale by researchers. Intraoral examination of the patients was carried out by researchers. The data were analyzed by independent-sample t-tests, Chi-square tests, paired-sample t-tests, and multivariate logistic regression (p < 0,05). RESULTS The patients had mean age 62.31 ± 10.70. Patients of 32.7% were with lung cancer. 52%of the patients (n = 128) receiving chemotherapy developed oral mucositis. The independent variables the presence chronic disease(OR:1.85), chemotherapy protocol (OR:3.52) and the dependent variables ECOG performance score (OR:2.25) were variable that affected the development of oral mucositis (p < 0.05). Patients of 35.5% were oral mucositis score of 1. Patients those who had breast cancer, who received doxorubicin or cyclophosphamide chemotherapy protocols, and who had previously developed oral mucositis were found to have a higher rate of oral mucositis (p < 0.05). In addition, oral mucositis was more prevalent in patients with chronic diseases other than cancer (57%), those who used medication continuously (57.2%), those with oral and dental diseases (56.9%), those who had dental check-ups before cancer treatment (79.2%), and those who had information about oral mucositis(70.2%) (p < 0.05). CONCLUSION In conclusion, nearly half of the patients (52%, n = 128) receiving chemotherapy developed oral mucositis and of all patients of 35.5% had an oral mucositis score of 1 in the second round of chemotherapy. Patients those who had breast cancer, who received doxorubicin or cyclophosphamide chemotherapy protocols, and who had previously developed oral mucositis were found to have a higher rate of oral mucositis.
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Affiliation(s)
- Seda Abali Pilas
- Babaeski State Hospital, Emergency Unit, Babaeski, Kırklareli, Turkey
| | - Seda Kurt
- Department of Medical Nursing, Faculty of Health Sciences, Trakya University, Edirne, Turkey.
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Tao Y, Zhang Y, Chen J, Wang L, Zhu N, Hu H. Effect of oral health education on improving knowledge, attitude, practice, and oral health status of patients with liver cancer: A quasi-experimental study. Eur J Oncol Nurs 2024; 71:102660. [PMID: 38968670 DOI: 10.1016/j.ejon.2024.102660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 06/06/2024] [Accepted: 06/30/2024] [Indexed: 07/07/2024]
Abstract
PURPOSE To evaluate the effectiveness of the PRECEDE-PROCEED model (PPM) in helping patients with liver cancer be aware of their knowledge, skills, and abilities in self-oral health behaviors and improve their oral health status. METHODS This is a quasi-experimental study of 90 patients with liver cancer assigned to an oral health education or a control group. The intervention group was educated with the PRECEDE-PROCEED model. A brief oral scale and the knowledge, attitude, and practice oral health questionnaire were employed to measure the oral health status and cognitive behavioral ability to seek oral health in patients. RESULTS Among 102 eligible patients, 90 (88.23%) agreed to participate in the present study and were divided to intervention (n = 45) or control (n = 45) groups. After the intervention and one month after discharge, the oral health scores of patients in the Intervention group were lower than those of the control group (P < 0.05). In addition, after the intervention and one month after discharge, the patients in the test group had higher scores on knowledge, beliefs, and behaviors of oral health than the control group (P < 0.05). One month after discharge, the mean knowledge and skills scores were significantly higher in the intervention group than in the control group. CONCLUSIONS Our findings suggest that oral health education may be a useful health intervention for patients with liver cancer. It may also improve the knowledge and beliefs of liver cancer patients seeking oral health. Larger long-term investigations are necessary to provide more support for these preliminary conclusions.
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Affiliation(s)
- Yue Tao
- Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Rd, Binhu District, Wuxi, Jiangsu Province, 214122, China; School of Medicine, Jiangnan University, Wuxi, 214122, China.
| | - Yan Zhang
- Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Rd, Binhu District, Wuxi, Jiangsu Province, 214122, China.
| | - Jie Chen
- Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Rd, Binhu District, Wuxi, Jiangsu Province, 214122, China.
| | - Leisheng Wang
- Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Rd, Binhu District, Wuxi, Jiangsu Province, 214122, China; School of Medicine, Jiangnan University, Wuxi, 214122, China.
| | - Na Zhu
- School of Medicine, Jiangnan University, Wuxi, 214122, China.
| | - Hao Hu
- Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Rd, Binhu District, Wuxi, Jiangsu Province, 214122, China; School of Medicine, Jiangnan University, Wuxi, 214122, China; Hepatobiliary and Pancreatic Surgery, The Third Hospital Affiliated to Nantong University, Wuxi, 214041, China; Medical School, Nantong University, Nantong, 226001, China; Wuxi Institute of Hepatobiliary Surgery, Wuxi, 214122, China.
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Colella G, Boschetti CE, Vitagliano R, Colella C, Jiao L, King-Smith N, Li C, Nuoh Lau Y, Lai Z, Mohammed AI, Cirillo N. Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials. Curr Oncol 2023; 30:967-980. [PMID: 36661723 PMCID: PMC9858113 DOI: 10.3390/curroncol30010074] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
Oral mucositis is a common and most debilitating complication associated with cancer therapy. Despite the significant clinical and economic impact of this condition, there is little to offer to patients with oral mucositis, and the medications used in its management are generally only palliative. Given that mucositis is ultimately a predictable and, therefore, potentially preventable condition, in this study we appraised the scientific literature to evaluate effective methods of prevention that have been tested in randomised controlled trials (RCTs). Published high-level evidence shows that multiple preventative methods are potentially effective in the prevention of oral mucositis induced by radiotherapy, chemotherapy, or both. Anti-inflammatory medications (including benzydamine), growth factors and cytokines (including palifermin), cryotherapy, laser-and-light therapy, herbal medicines and supplements, and mucoprotective agents (including oral pilocarpine) showed some degree of efficacy in preventing/reducing the severity of mucositis with most anticancer treatments. Allopurinol was potentially effective in the prevention of radiotherapy-induced oral mucositis; antimicrobial mouthwash and erythropoietin mouthwash were associated with a lower risk of development of severe oral mucositis induced by chemotherapy. The results of our review may assist in highlighting the efficacy and testing the effectiveness of low-cost, safe preventative measures for oral mucositis in cancer patients.
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Affiliation(s)
- Giuseppe Colella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Ciro Emiliano Boschetti
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Rita Vitagliano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Chiara Colella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Lebei Jiao
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
| | - Natalie King-Smith
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
| | - Chong Li
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
| | - Yii Nuoh Lau
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
| | - Zacchaeus Lai
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
| | - Ali Ibrahim Mohammed
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
| | - Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
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Protective Role of Natural Compounds under Radiation-Induced Injury. Nutrients 2022; 14:nu14245374. [PMID: 36558533 PMCID: PMC9786992 DOI: 10.3390/nu14245374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
In recent years, evidence has shown the potential therapeutic effects of different natural compounds for the prevention and treatment of radiotherapy-induced mucositis (RIOM). RIOM represents one of the most frequent side effects associated with anti-neoplastic treatments affecting patients' quality of life and treatment response due to radiation therapy discontinuation. The innate radio-protective ability of natural products obtained from plants is in part due to the numerous antioxidants possessed as a part of their normal secondary metabolic processes. However, oxygen presence is a key point for radiation efficacy on cancer cells. The aim of this review is to describe the most recent evidence on radiation-induced injury and the emerging protective role of natural compounds in preventing and treating this specific damage without compromising treatment efficacy.
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Guberti M, Botti S, Caffarri C, Cavuto S, Savoldi L, Fusco A, Merli F, Piredda M, De Marinis MG. Efficacy and safety of a colostrum- and Aloe vera-based oral care protocol to prevent and treat severe oral mucositis in patients undergoing hematopoietic stem cell transplantation: a single-arm phase II study. Ann Hematol 2022; 101:2325-2336. [PMID: 35922679 PMCID: PMC9463213 DOI: 10.1007/s00277-022-04934-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/24/2022] [Indexed: 11/12/2022]
Abstract
Oral mucositis is one of the worst effects of the conditioning regimens given to patients undergoing hematopoietic stem cell transplantation. It is characterized by dry mouth, erythema, mucosal soreness, ulcers, and pain, and it may impact patient outcomes. Bovine colostrum and Aloe vera contain a wide variety of biologically active compounds that promote mucosal healing. A non-randomized phase II study was designed to assess the safety and efficacy of a combined bovine colostrum and Aloe vera oral care protocol to prevent and to treat severe oral mucositis in transplant patients. Two commercially available products were given to patients in addition to the standard protocol: Remargin Colostrum OS® mouthwash and Remargin Colostrum Gastro-Gel® taken orally. Forty-six (78.0%) patients experienced oral mucositis, 40 (67.8%) developed mild-moderate forms, and 6 (10.2%) severe ones. Comparing the study group's outcomes with those of a homogeneous historical control group, severe oral mucositis decreased significantly (10.2% vs. 28.4%; P < 0.01), as did its duration (0.5 ± 1.9 vs. 1.5 ± 3.0 days; P < 0.01). Febrile neutropenia episodes (69.5% vs. 95.1%; P < 0.01) and duration (4.0 ± 4.7 vs. 6.2 ± 4.5 days; P < 0.01) also decreased. These findings show that the experimental protocol seems effective in preventing severe forms of oral mucositis. However, a randomized controlled trial is necessary to confirm this.
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Affiliation(s)
- Monica Guberti
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Via Montpellier, 1 - 00133 Rome, Italy
| | - Stefano Botti
- Hematology Unit, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Cristiana Caffarri
- Hematology Unit, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Silvio Cavuto
- Clinical Trials and Statistics Unit, SC Infrastructure, Research and Statistics, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42123 Reggio Emilia, Italy
| | - Luisa Savoldi
- Clinical Trials and Statistics Unit, SC Infrastructure, Research and Statistics, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42123 Reggio Emilia, Italy
| | - Andrea Fusco
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Francesco Merli
- Hematology Unit, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Michela Piredda
- Research Unit Nursing Science, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Maria Grazia De Marinis
- Research Unit Nursing Science, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
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Bezerra PMM, Vieira TI, Dos Santos FG, Ribeiro ILA, de Sousa SA, Valença AMG. The impact of oral health education on the incidence and severity of oral mucositis in pediatric cancer patients: a systematic review and meta-analysis. Support Care Cancer 2022; 30:8819-8829. [PMID: 35915339 DOI: 10.1007/s00520-022-07296-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/22/2022] [Indexed: 10/16/2022]
Abstract
Oral health education is an effective measure to prevent oral mucositis (OM) by improving self-management and effectively engaging patients in their health care. This systematic review aimed to determine the impact of oral health education interventions on the incidence and severity of OM. Bibliographical searches were carried out by two independent examiners in Medline, Scopus, Web of Science, Cochrane Library, Virtual Health Library, and SIGLE, until June 2022. The eligibility criteria were based on the PICO strategy, considering studies with pediatric oncology patients, aged 0 to 19 years, who had attended oral health education activities and had been examined for the incidence and/or severity of OM. Data were extracted for qualitative synthesis and organized in spreadsheets. The quality assessment of the selected studies was performed using the ROBINS-I tool. Meta-analysis was based on the group frequencies of OM ulcerative lesions, adopting a significance level of 5%. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to define the certainty of the evidence. The primary search retrieved 1827 articles. After removing duplicate records and screening titles and abstracts for eligibility, a total of 21 articles were selected for full-text analysis. Of these, seven eligible studies were included for data extraction and qualitative synthesis, while four studies were selected for quantitative synthesis. All studies had a longitudinal design; three performed a before-after comparison and four were controlled studies. OM was assessed by the following scales: OAG, WHO, ChIMES, and WCCNR. While data analysis of the selected studies was heterogeneous, the implementation of oral health education strategies was found to reduce the incidence and severity of OM during the follow-up period. The meta-analysis showed a favorable outcome for the educational intervention. The likelihood of patients attending oral health education activities to manifest OM ulcerative lesions was significantly lower (P = 0.002) than that of the control. The GRADE analysis presented a low certainty of the evidence. To conclude, oral health education interventions improved OM outcomes in pediatric oncology patients with a low quality of evidence.
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Affiliation(s)
| | - Thiago Isidro Vieira
- Postgraduate Program in Dentistry, Federal University of Paraíba, 58051-900, João Pessoa PB, Brazil
| | - Fabio Gomes Dos Santos
- Postgraduate Program in Dentistry, Federal University of Paraíba, 58051-900, João Pessoa PB, Brazil
| | | | - Simone Alves de Sousa
- Postgraduate Program in Dentistry, Federal University of Paraíba, 58051-900, João Pessoa PB, Brazil
| | - Ana Maria Gondim Valença
- Postgraduate Program in Dentistry, Federal University of Paraíba, 58051-900, João Pessoa PB, Brazil
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Rathore J, Pandey V, Bishnoi AK, Nair SK. Effectiveness of Video-Assisted Educational Program Regarding Prevention of Oral Mucositis among Patients Receiving Radiotherapy. Indian J Palliat Care 2022; 28:307-313. [PMID: 36072247 PMCID: PMC9443113 DOI: 10.25259/ijpc_143_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/07/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives: Oral mucositis refers to erythematous and ulcerative lesions in the oral mucosa observed in patients with head and neck cancer receiving radiotherapy (RT). It is an acute complication or side effect of RT. The aim of the study was to assess the effectiveness of video assisted educational program regarding the prevention of oral mucositis in terms of knowledge and reported practices among patients receiving RT. Materials and Methods: A quantitative approach, pre-experimental one group pre-test post-test design was used among 50 head and neck cancer patients coming to the radiation unit by non-probability purposive sampling technique. Structured knowledge interview schedule tools, that is, socio-demographic variables, knowledge MCQ’s and reported practices rating scale were used. Data analysis was performed using Statistical Package for the Social Sciences version 20. Results: The study findings reveal that there is a significant improvement in the level of knowledge of patients (t = 4.54, P < 0.05) and reported practices of patients (t = 6.08, P < 0.05) which proves that video-assisted educational program on oral mucositis prevention was effective in improving the knowledge and practices of head and neck cancer patients. The result shows a significant association of pre-test reported practices with the occupation of the patient. There is a moderately positive correlation (0.54) between knowledge and reported practices in pre-test and a strong positive correlation (0.76) between knowledge and reported practices in post-test. Conclusion: The present study reveals that video-assisted educational program regarding the prevention of oral mucositis was effective in improving the knowledge and reported practices among head and neck cancer patients receiving RT.
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Affiliation(s)
- Jyoti Rathore
- Department of Nursing, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India,
| | - Vandana Pandey
- Assistant Professor, Department of Nursing, College of Nursing, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India,
| | - Ashok Kumar Bishnoi
- Associate Professor, Department of Nursing, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India,
| | - Shrikant K. Nair
- Nusing Tutor, Department of Nursing, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India,
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Yoshida K, Kodama Y, Tanaka Y, Pak K, Soga M, Toyama A, Katsura K, Takagi R. Pharmacist involved education program in a multidisciplinary team for oral mucositis: Its impact in head-and-neck cancer patients. PLoS One 2021; 16:e0260026. [PMID: 34807914 PMCID: PMC8608342 DOI: 10.1371/journal.pone.0260026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 11/01/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This retrospective study examined how a pharmacist-involved education program in a multidisciplinary team (PEMT) for oral mucositis (OM) affected head-and-neck cancer (HNC) patients receiving concurrent chemoradiotherapy (CCRT). MATERIALS AND METHODS Total samples data of 53 patients during the stipulated timeframe were retrospectively collected from electronic medical records from February 2017 to January 2019. We compared the presence/absence of OM (OM: yes/no) between patients with and without PEMT (PEMT: yes/no) as the primary endpoint and OM severity as the secondary endpoint. The following information was surveyed: age, gender, weight loss, steroid or immunosuppressant use, hematological values (albumin, white blood cell count, blood platelets, and neutrophils), cancer grade, primary cancer site, type and use of mouthwash and moisturizer, opioid use (yes/no, days until the start of opioid use, and dose, switch to tape), and length of hospital day (LOD). The two groups were compared using Fisher's exact test for qualitative data and the Mann-Whitney U test for quantitative data, and a significance level of p<0.05 was set. RESULTS The group managed by PEMT had significantly lower weight loss and a significantly lower incidence of local anesthetic and opioid use and switch to tape compared with the group not managed by PEMT (p<0.05). The two groups showed no significant difference in OM (yes/no) or OM severity. The PEMT group had significantly shorter LOD at 57 (53-64) days compared with the non-PEMT group at 63.5 (57-68) days (p<0.05). CONCLUSIONS Our results showed that PEMT did not improve OM (yes/no) or OM severity in HNC patients undergoing CCRT. However, the PEMT group had a lower incidence of grades 3 and 4 OM than the non-PEMT group, although not significantly. In addition, PEMT contributed to oral pain relief and the lowering of the risk for OM by reduction in weight loss.
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Affiliation(s)
- Kensuke Yoshida
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yasumitsu Kodama
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Yusuke Tanaka
- Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kyongsun Pak
- Division of Biostatistics, Center for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | - Marie Soga
- Division of Oral Radiology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Akira Toyama
- Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kouji Katsura
- Division of Oral Radiology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Ritsuo Takagi
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Alizadeh M, Moradi S, Zaboli E, Emadian SF, Ghorbani A, Hedayatizadeh Omran A, Alizadeh Navaei R. Improvement in use of best practice in the care of patients with oral mucositis in a comprehensive cancer center in Iran: a best practice implementation case study. JBI Evid Implement 2021; 20:101-110. [PMID: 34433188 DOI: 10.1097/xeb.0000000000000292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Oral mucositis is a common debilitating complication of cancer treatments, particularly chemotherapy and radiation. OBJECTIVES The purpose of this study was to improve oral mucositis prevention and control among cancer patients through the implementation of best practice guidelines in a tertiary referral center in Northern Iran. METHODS A clinical audit design was utilized in this implementation project. A preimplementation audit was conducted against nine best practice criteria for the prevention and treatment of oral mucositis among new cases of cancer patients in November and December 2019. Fifty cancer patients and 20 nurses participated in this phase of the clinical audit. The next step included a facilitated multidisciplinary focus group identifying targeted strategies and implementing them, completed in late December 2019. A postimplementation audit was then conducted on another 50 cancer patients and the same 20 nurses in January and early February 2020. The project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice software. RESULTS The preimplementation audit revealed gaps between the current practice and best practice across eight of the nine criteria. After implementing the targeted strategies, the outcomes improved across most of the criteria in the follow-up audit: 80% increase was observed in compliance of staff education, 100% increase in providing standard oral hygiene protocol in place, 64% increase in carrying out a dental examination and conducting initial oral cavity examination, and also 34% increase in conducting of ongoing oral cavity examination by a dentist, and finally 100% increase in providing preventive and therapeutic oral care regimens in place and oral pain assessment using a validated tool. CONCLUSION The results of this project indicate that clinical auditing is an effective approach to the assessment of evidence-based care practices for oral mucositis among new cancer patients. Evidence-based oral mucositis management among cancer patients can be achieved by educating the patients and nursing staff using the newest guidelines and dentists' comprehensive dental and oral hygiene examinations.
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Affiliation(s)
- Mahasti Alizadeh
- Research Center for Evidence-based Medicine, Iranian EBM Center: A Joanna Briggs Institute (JBI) Center of Excellence, Tabriz University of Medical Sciences, Tabriz
| | | | | | | | - Anahita Ghorbani
- Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
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Nigella sativa Oil Mouth Rinse Improves Chemotherapy-Induced Oral Mucositis in Patients with Acute Myeloid Leukemia. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3619357. [PMID: 31781612 PMCID: PMC6875195 DOI: 10.1155/2019/3619357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/30/2019] [Accepted: 09/14/2019] [Indexed: 01/20/2023]
Abstract
Objective The present study aims at evaluating the beneficial effect of Nigella sativa (NS) oil mouth rinse in the management of chemotherapy- (CT-) induced oral mucositis (OM) in patients with acute myeloid leukemia (AML). Methods Fifty-four AML patients were participated in this study and randomly allocated to either the test group or a control group. The patients of the test group received NS oil mouth rinse during 28-day CT, while the participants of the control group received a "magic mouthwash" formula. The primary outcome of this study was the incidence and severity of CT-induced OM in terms of erythema and ulcer. The secondary outcomes were the pain severity score, swallowing function, and the salivary concentrations of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). Results NS oil mouth rinse attenuated the progression of CT-induced OM compared with the control formula (AUC = 5.9 vs. 38.4, P < 0.05) and significantly decreased the erythema and ulceration scores (AUC of total OMAS = 11.4 vs. 85.9, P < 0.001) compared with the magic mouthwash formula. It also reduced the pain score and enabled all the participants of this group to consume normal food during treatment. It significantly decreased salivary IL-6 (AUC = 7376 vs. 16599, P < 0.001), while the changes of TNF-α levels were not significant (AUC = 676.9 vs. 885.2, P > 0.05). Conclusions NS oil mouth rinse is effective in attenuating the severity of CT-induced OM and improves the pain and swallowing function in AML patients.
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Hong CHL, Gueiros LA, Fulton JS, Cheng KKF, Kandwal A, Galiti D, Fall-Dickson JM, Johansen J, Ameringer S, Kataoka T, Weikel D, Eilers J, Ranna V, Vaddi A, Lalla RV, Bossi P, Elad S. Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer 2019. [DOI: 10.1007/s00520-019-04848-4%0a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer 2019; 27:3949-3967. [DOI: 10.1007/s00520-019-04848-4] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 04/30/2019] [Indexed: 11/27/2022]
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Hekmatpou D, Nasiri A, Mohaghegh F. Investigating the Effect of Self-Care Training on Life Expectancy and Quality of Life in Patients with Gastrointestinal Cancer under Radiotherapy. Asia Pac J Oncol Nurs 2019; 6:198-205. [PMID: 30931366 PMCID: PMC6371673 DOI: 10.4103/apjon.apjon_47_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective: A huge amount of the efforts made by health teams is dedicated to caring for cancer patients. This study has aimed to investigate the effect of self-care training on life expectancy and quality of life (QOL) in patients with gastrointestinal cancer who were under radiotherapy. Methods: In this clinical trial, 50 patients were selected using the block randomization method. The intervention was performed at Ayatollah Khansari Hospital in Arak, Iran. The patients in the intervention group received three sessions of face-to-face training. The data collection tools included Schneider's Life Expectancy Questionnaire and EORTC QOLQ-C30. Data were analyzed by SPSS version 23. Results: In the control group, 16 were male (64%) and 9 female (36%), and in the intervention group, 14 were male (56%) and 11 were female (44%). Before the intervention, the two groups were homogenous regarding all variables. After the intervention, the mean of QOL was 67 ± 22.62 in the intervention group and 56 ± 18.55 in the control group (P < 0.05). In examining the different dimensions of QOL, improvement in all functional dimensions was observed in the intervention group. After the intervention, the mean score of life expectancy showed a significant difference (P < 0.05) between the intervention group (39.52 ± 5.26) and the control group (31.6 ± 7.13). Conclusions: It was found that self-care training improved the QOL and life expectancy of patients with gastrointestinal cancer who were under radiotherapy. Therefore, self-care training is recommended to improve the QOL and the life expectancy of cancer patients.
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Affiliation(s)
- Davood Hekmatpou
- Nursing Department, Nursing and Midwifery Faculty, Arak University of Medical Sciences, Arak, Iran
| | - Azadeh Nasiri
- Nursing Department, Nursing and Midwifery Faculty, Arak University of Medical Sciences, Arak, Iran
| | - Fatholah Mohaghegh
- Medicine Department, Medical Faculty, Arak University of Medical Sciences, Arak, Iran
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Arshadi Bostanabad M, Alvandnezhad T, Hiradfar A, Mohammadpoorasl A, Khalvati B. Level of Education Provided by Nurses to the Parents of Children with Chemotherapy-Induced Mucositis. JOURNAL OF CLINICAL AND BASIC RESEARCH 2018. [DOI: 10.29252/jcbr.2.2.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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