Abstract
PurposeDry mouth is a highly prevalent and significant symptom in patients with advanced progressive diseases. It is a poorly understood area of research, and currently, there is no standardised outcome measure or assessment tool for dry mouth.MethodsTo assess responses to self-reported dry mouth questions, the impact of dry mouth, methods used to reduce symptoms and relevance of the questionnaire. A cross-sectional multisite study of 135 patients with advanced progressive disease experiencing dry mouth. Participants were located in the inpatient, day care, outpatient or community setting.ResultsThe majority (84.4%) of patients rated their dry mouth as moderate or severe using the verbal rating scale (VRS). Seventy-five percent (74.7%) had a numeric rating scale (NRS) score of 6 or more for dry mouth severity. Patients reported that dry mouth interfered most with talking and was the most important function to assess (median score 6 out of 10) followed by eating (median 5) and taste (median 5). Taking sips of drink was the most common and most effective self-management strategy. Over half of patients (54.6%) also reported impact on swallow and sleep and associated dryness of lips, throat and nasal passages.ConclusionsThis study highlights the severity of dry mouth in advanced disease. Important factors when assessing patients with dry mouth should include the functional impact on day-to-day activities including talking, dysphagia and sleep. Simple considerations for patients include provision of drinks and reviewing medications. This study could be used to develop a standardised assessment tool for dry mouth to use in clinical practice.
Highlights
Dry mouth is a highly prevalent and significant symptom for patients with advanced progressive diseases
Our study found that most patients with advanced disease that have previously been identified as having a dry mouth rated their dry mouth as moderate or severe using a verbal rating scale (VRS), or at least a 6 out of 10 on a numeric rating scale (NRS), for dry mouth severity
Given the prevalence and impact of dry mouth in advanced disease, and the paucity of the existing evidence base, more research is needed if improvements in quality of life are to be realised for these patients
Summary
Dry mouth is a highly prevalent and significant symptom for patients with advanced progressive diseases. In a UK study of 197 terminally ill cancer patients, it was the most prevalent symptom, occurring in 77% [2]. One of the first studies on the epidemiology, aetiology and clinical features of dry mouth in advanced cancer patients was published in 2001 [4]. 78% of 120 patients reported dry mouth; it was the fourth most common symptom reported on a Memorial symptom assessment scale (MSAS) and the 3rd most distressing symptom. The majority (75%) of the patients reported by Davies [4] experienced dry mouth either ‘frequently’ or ‘almost constantly’, and 86% rated the severity as either ‘moderate’, ‘severe’ or ‘very severe’
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