Abstract
Most patients in palliative care have problems with dry mouth caused by medication or as a direct result of their condition. Dry mouth may cause problems that affect the primary disease negatively and contribute to poorer quality of life in palliative patients. This randomized controlled trial compared the efficacy of three different oral moisturizers: 17% watery solution of glycerol; oxygenated glycerol triester (marketed as Aequasyal in Europe and as Aquoral in the USA); and a newly developed product, Salient. Of the three products, glycerol provided the best relief from xerostomia directly after application, but had no effect after 2h. By contrast, the effects of Aequasyal and Salient were largely maintained over the same period. The findings for oral discomfort and pain and speech problems showed a similar pattern. Despite its poor effect after 2h, patients preferred glycerol over Salient and Aequasyal, probably because of the unpleasant taste of Aequasyal and the consistency and mode of application of Salient. Within the limitations of this study, none of the three products tested was found to be clinically completely adequate. However, the glycerol solution was preferred by this group of patients, and its short-lived effect can be compensated for by frequent applications.
Highlights
Palliative care is the active treatment and care for patients with incurable diseases and short life expectancy
By applying the World Health Organization (WHO) performance status scale, which ranges from grade 0 to grade IV [6], the cause of the patient’s decline can be described
The present paper reports findings from a randomized controlled trial (RCT) in which the efficacy of three moisturizers [17% watery solution of glycerol, oxygenated glycerol triester (OGT), and a newly developed product (Salient)] was compared
Summary
Palliative care is the active treatment and care for patients with incurable diseases and short life expectancy. Many patients in palliative care have received treatment or medications that may have adverse effects on oral health. Other disease-related factors that may have adverse effects on oral health are dehydration, difficulties in chewing, impaired immune response, unfavourable changes in bacterial flora and secondary infections, anxiety and depression, impaired motor function, and an inability to self-care [10,11,12]. A range of different products are used in an effort to alleviate the symptoms of dry mouth. The present paper reports findings from a randomized controlled trial (RCT) in which the efficacy of three moisturizers [17% watery solution of glycerol, OGT, and a newly developed product (Salient)] was compared. The trial was designed to answer the following question: Do any of the three agents improve xerostomia, reduce pain and discomfort, and improve ability to talk in palliative care patients? The hypothesis was that there was no difference in efficacy between 17% glycerol, OGT, and Salient
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