Abstract
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). 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. 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). 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.
Highlights
Oral mucositis (OM) has been described as the most painful aspect of chemotherapy [1]
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
Our results showed that PEMT did not improve OM or OM severity in head and neck cancer (HNC) patients undergoing concurrent chemoradiotherapy (CCRT)
Summary
Oral mucositis (OM) has been described as the most painful aspect of chemotherapy [1]. A multidisciplinary medical team approach has been shown to be protective against OM in patients Such approach supports treatment and evaluations by dentists, professional oral care delivered by dental hygienists, and daily care and mental health follow-ups provided by nurses. Pharmacists have been providing patient education on oral care since February 2018 with the goal of increasing adherence to mouth washing and moisturizing. These pharmacists were trained via an oral care program offered by dentists. We examined how a pharmacist-involved education program in a multidisciplinary team (PEMT) for OM affected HNC patients receiving concurrent chemoradiotherapy (CCRT)
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