Using the Glasgow Benefit Inventory questionnaire to quantify the health benefits of lymphoedema treatment in patients with head and neck cancer

Edwin Halliday,Jayne Gittins,Syed Farhan Ahsan

doi:10.1186/s41241-020-00093-y

Edwin Halliday, Jayne Gittins + Show 1 more

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https://doi.org/10.1186/s41241-020-00093-y

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Abstract

BackgroundLymphoedema is a common side effect after treatment for head and neck cancer. Our treatment protocol involves staging the degree of lymphoedema and then offering treatment comprising skin care, manual lymphatic drainage, simple lymphatic drainage, compression and elastic therapeutic tape. The Glasgow Benefit Inventory is a validated post-interventional questionnaire applicable to otorhinolaryngology interventions which measures changes in health status. The aim of this study was to quantify the health benefits of lymphoedema treatment using the Glasgow Inventory Benefit questionnaire, in patients with a history of treated head and neck cancer.MethodsAny patient who had undergone treatment with curative intent of a primary head and neck malignancy who had been referred for lymphoedema treatment within a 6 month period was eligible for inclusion. Patients completed a questionnaire after finishing the course of lymphoedema treatment.ResultsA total of 15 patients completed the questionnaire. Ten patients (67%) demonstrated some level of improvement in quality of life, while two (13%) reported no benefit and three (20%) reported negative improvements. The average score for the total Glasgow Benefit Inventory scale was + 7.2. The greatest benefit was demonstrated with the physical benefit subscale (+ 13.1). The average general benefit score was + 9.0.ConclusionsLymphoedema treatment involves techniques which can fairly easily be taught to patients to complete at home. In this study, there were mild improvements in patient reported quality of life using the Glasgow Benefit Inventory in the majority of patients. Clinical interest has increased in lymphoedema recently, but there is still limited information about the effectiveness of treatments and future research should look to address these issues.

Highlights

Lymphoedema is a common side effect after treatment for head and neck cancer
For patients with more severe oedema, or those with mild/moderate oedema but substantial symptoms of psychological distress resulting in poor quality of life, the treatment plan was altered to include a course of manual lymphatic drainage (MLD) over four to six visits
We describe using the Glasgow Benefit Inventory, a validated post-interventional questionnaire, to measure patient reported outcomes in relation to health status after treatment for lymphoedema

Summary

Introduction

Lymphoedema is a common side effect after treatment for head and neck cancer. The aim of this study was to quantify the health benefits of lymphoedema treatment using the Glasgow Inventory Benefit questionnaire, in patients with a history of treated head and neck cancer. There is inadequate drainage of the high protein lymphatic fluid caused by radiotherapy or surgery which may remove lymph nodes entirely or disrupt lymphatic flow. This results in overload of lymphatic fluid within the interstitial tissues which often produces internal and external oedema [5, 6]. It is important to acknowledge that psychosocial distress is often a major symptom accompanying treatment for head and neck cancers, if lymphoedema develops [6, 8]

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