PROMs and PREMs in Dutch integrated head and neck cancer care.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6570-6570
Author(s):  
Rosella Hermens ◽  
Lydia Francisca Jacoba van Overveld ◽  
Robert P. Takes ◽  
Jozé C.C. Braspenning ◽  
Ludi E Smeele ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Mixed Model ◽  
Mixed Model Analysis ◽  
Treatment Groups ◽  
Patient Reported ◽  
Over Time ◽  
Domain Scores

6570 Background: Providing patient-centred care is an essential component of high quality integrated care. A method to get insight in patients perspectives about the quality of health care they received, is measuring Patient Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs). We aimed to determine the outcomes of, and differences between PROs and PREs over time and between treatment groups for patients with head and neck cancer (HNC). Methods: Patientswere recruited from nine hospitals participating in the DHNA. Validated questionnaires were distributed at baseline, 3, 6 and 12 months follow-up. Included PROMs were EuroQol 5 Dimension 3 Level (EQ-5D-3L), EORTC QLQ-C30 and -H&N35. Included PREMs, Consumer Quality index for Oncologic care (CQO) and Radiotherapeutic care (CQR), have similar domains with different questions. With descriptive analysis, ANOVA and mixed model analysis, differences over time and between treatment groups were analyzed. Results: Questionnaires were filled in by 426 patients. Pain decreased significantly at 6 and 12 months follow-up (14 and 21 points on a scale of 0-100) and dry mouth increased significantly at 3, 6 and 12 months follow-up compared to baseline (35, 27 and 20 points). Sticky Salvia, problems with social eating and sense problems increased at 3 and 6 months follow-up, but were similar to the baseline score at 12 months follow-up. Pain and sticky saliva differed between radiotherapy and chemoradiotherapy or surgery and radiotherapy respectively (p≤0.05). Regarding the CQO domain scores, all treatment groups differed significantly from each other (p≤0.05), especially for the domain Personal input. There was no difference regarding the CQR domain scores. Recognizing the emotional side of HNC and guidance after the treatment scored low in patients. Conclusions: This study gives clues to improve healthcare according the experiences of the patient and we can predict more carefully the outcomes of the patients with different treatment types. PROMs according to the ICHOM criteria and PREMs are promising for measuring and improving quality and personalization of HNC care. However, recognizing the emotional side of HNC and intensifying guidance after the treatment period needs improvement.

PROMs and PREMs in Dutch integrated head and neck cancer care: Measurements and evaluation.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 209-209
Author(s):  
Lydia Francisca Jacoba van Overveld ◽  
Robert P. Takes ◽  
Jozé C.C. Braspenning ◽  
Ludi E Smeele ◽  
Matthias A.W. Merkx ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Patient Reported Outcomes ◽  
Patient Centred Care ◽  
Treatment Groups ◽  
Patient Reported ◽  
Eortc Qlq ◽  
Domain Scores

209 Background: Providing patient-centred care is an essential component of high quality integrated care. Nowadays, patient reported outcomes and experiences are increasingly used to measure quality of care. As part of a quality registration, the Dutch Head and Neck Audit, patient reported outcomes (PROs) and experiences (PREs) of patients with head and neck cancer (HNC) are measured with questionnaires and evaluated to increase patient-centred care. Methods: Patientswere recruited from nine hospitals participating in the DHNA. Validated questionnaires were distributed at baseline, 3, 6 and 12 months follow-up. Included PROMs were EQ-5D-3L, EORTC QLQ-C30 and EORTC QLQ-H&N35. Included PREMs were Consumer Quality index for Oncologic care (CQO) and Radiotherapeutic care (CQR). CQO and CQR have similar domains with different questions. With descriptive analysis, ANOVA and mixed model analysis, differences over time and between treatment groups were analyzed. Results: Questionnaires were filled in by 238 patients. Pain decreased significantly at 6 and 12 months follow-up and dry mouth increased significantly at 3, 6 and 12 months follow-up compared to baseline. Sticky Salvia, problems with social eating and sense problems increased at 3 and 6 months follow-up, but were similar to the baseline score at 12 months follow-up. Pain and sticky saliva differed between radiotherapy and chemoradiotherapy or surgery and radiotherapy respectively (p ≤ 0.05). Regarding the CQO domain scores, all treatment groups differ significantly from each other (p ≤ 0.05). This was not regarding the CQR domain scores. Except for the domain Organisation, no differences between the CQO and CQR domain scores were found. Recognizing the emotional side of HNC (care) and intensifying guidance after the treatment period needs improvement. Conclusions: This study gives clues to improve healthcare according the experiences of the patient and we can predict more carefully the outcomes of the patients with different treatment types. PROMs according to the ICHOM criteria and PREMs are promising for measuring and improving quality and personalization of HNC care. However, the usage of two PREMs had no added value to evaluate and address points of improvement.

Measuring impact of survivorship care plans on head and neck cancer patients.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 73-73
Author(s):  
Bridgett Ann Harr ◽  
Joanna Bodmann ◽  
Shlomo A. Koyfman ◽  
Tobenna Igweonu Nwizu ◽  
Nikhil Purushottam Joshi ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Survivorship Care Plan ◽  
Patient Specific ◽  
Survivorship Care ◽  
Care Plans ◽  
The Impact ◽  
Over Time

73 Background: At our institution, patients who have completed treatment for a locoregionally confined head and neck cancer are followed in a multidisciplinary head and neck survivorship clinic initiated by the administration of a formal, patient specific survivorship care plan (SCP). We sought to assess the impact of these SCP visits on patient understanding of their disease, its treatment, and potential late effects and follow up plans. Methods: An IRB approved survey was administered by an uninvolved third party, to an unselected sequential series of head and neck cancer survivorship patients at the time of a regularly scheduled follow up visit. The survey focused on the knowledge recalled from the SCP, and whether this changed over time. We analyzed two cohorts of patients, based on whether the SCP had been given to them within the last 18 months or not. Results: Preliminary results from the first 20 patients surveyed are presented. These patients received their SCP 3-27 months before being surveyed. Primary tumor sites included oropharynx (16) and larynx (4) and most patients had been treated with intensity modulated radiation therapy (19) and concurrent cisplatin (11). Conclusions: Although patients’ recall about receiving a formal SCP appeared to diminish over time, the information provided by this SCP plan and subsequent survivorship visits was retained. Whether this reflected the SCP itself, or the reinforcement of continued close follow up survivorship visits cannot be determined, but merits further investigation. [Table: see text]

scholarly journals Contribution of long-term dysphagia monitoring to first line treatment of head and neck cancer patients

2018 ◽  
Vol 4 (6) ◽  
pp. 1331
Author(s):  
Marie Noëlle Falewee ◽  
Christophe Hebert ◽  
Karen Benezery ◽  
Alexandre Bozec ◽  
Joël Guigay ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Strong Impact ◽  
Patient Reported ◽  
Long Term Follow Up ◽  
First Time

<p class="abstract"><strong>Background:</strong> Dysphagia is a serious sequel of head and neck cancer (HNC) and its treatment. This dysfunction is frequent and likely underreported by clinical exam. It seems necessary to assess its global burden during the pre, per and post treatment periods (up to 18 months), regardless of the treatment received.</p><p class="abstract"><strong>Methods:</strong> This was a prospective cohort study assessing the rate of dysphagia in first-time treated HNC patients, using the deglutition handicap index questionnaire (DHI) and the clinician reporting. Time to occurrence, severity and length of the dysfunction were recorded. The benefit of an evaluation by the patient himself was investigated.  </p><p class="abstract"><strong>Results:</strong> Of 134 evaluable patients: 22 were treated by surgery alone (16.4%), 16 by radiotherapy (RT) alone (11.9%), 3 by chemotherapy (CT) alone (2.2%), 28 by RTCT (20.9%), 31 by induction chemotherapy followed by RTCT (23.1%), 11 by surgery+RT (8.2%) and 23 by surgery+RTCT (17.2%). Patients completed 87.9% of the expected DHI. The dysphagia frequency reported was 92.2% by patient-reporting and 80.9% by clinicians-reporting, whatever the intensity. Self-perceived moderate to severe dysphagia was reported in 69.8% of patients.</p><p class="abstract"><strong>Conclusions:</strong> Given the strong impact of dysphagia on the quality of life and prognosis of HNC patients, it appears essential to perform screening and systematic monitoring. Using a simple and well accepted questionnaire, such as DHI, which is also well correlated with clinical evaluation, we demonstrated a significant frequency of dysphagia. The use of real-time patient-reported outcomes for its early detection would be an asset, particularly during long-term follow-up.</p><p class="abstract">Registered under ClinicalTrials.gov Identifier no. NCT03068559.</p>

ARIX: A randomized trial of acupuncture versus oral care sessions in patients with chronic radiation-induced xerostomia following treatment for head and neck cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5527-5527
Author(s):  
Richard Simcock ◽  
Lesley Fallowfield ◽  
Kathryn Monson ◽  
Ivonne Solis-Trapala ◽  
Louise Parlour ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Oral Care ◽  
Dry Mouth ◽  
Patient Reported ◽  
Radiation Induced ◽  
Carry Over ◽  
Weekly Group ◽  
Over Time

5527 Background: Radiation induced xerostomia impairs quality of life of in head and neck cancer survivors. Prior small non-randomised studies suggest that acupuncture may alleviate symptoms. We report the first large randomised trial comparing 8 weeks of group acupuncture with oral care sessions as a control. Methods: 145 patients with radiation induced xerostomia>18 months were recruited from 7 UK Cancer centres. Subjects received standardised group sessions of oral care (OC) education and 8 sessions of weekly group acupuncture (A) in a randomised crossover design with a 4 week washout (Group One OC/A and Group Two A/OC). Acupuncture was standardised to a technique previously piloted (3 auricular points and two distal points bilaterally). Patients completed the EORTC QLQ H&N questionnaire at baseline and weeks 5, 9, 13, 17 and 21 in addition to rating 4 key dry mouth symptoms. The primary outcome was patient reported improvement in dry mouth symptoms. The statistical analysis was longitudinal based on logistic regression models and adjustment for potential carry over. Stimulated and unstimulated saliva was measured. Results: An improvement for 5/7 symptoms was noted following acupuncture. In Group One 24% showed improvement 8 weeks following A (19% after OC). In Group Two 26% reported improvement in severe dry mouth after A (14% after OC). The estimated OR of improved dry mouth 5 weeks after A compared to OC was 2.0 (p=0.031), after adjusting for effects of time, potential carry-over, centre and patient characteristics. The estimated odds ratios of improvement in severity of symptoms for A compared to OC were (OR=1.67, p=0.048) for sticky saliva, (OR=2.08, p=0.011) for needing to sip to swallow food and (OR=1.71, p=0.013) for waking up at night needing to drink. Mean attendance rate for A was 89% and 80% for OC. There was no significant change in saliva production over time or by intervention. Mean global QoL score did not change significantly over time either within or between groups. No adverse events were seen. Conclusions: Eight sessions of weekly group acupuncture provides significantly better relief of radiation induced xerostomia than group oral care education.

Neutrophilic Dermatosis of Hands as Oncological Finding: Importance of Follow-Up

ORL ◽  
2021 ◽  
pp. 1-3
Author(s):  
Jérôme R. Lechien ◽  
Daphné Delplace ◽  
Mohamad Khalife ◽  
Sven Saussez
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Paraneoplastic Syndrome ◽  
Tobacco Consumption ◽  
Neutrophilic Dermatosis ◽  
Pharyngeal Cancer ◽  
Head And Neck Malignancy ◽  
Neck Malignancy

Neutrophilic febrile dermatosis (NFD) is a rare paraneoplastic syndrome that may be found in patients with head and neck cancer. NFD may appear before the neoplasia and may only concern the dorsal faces of the hands. This article reports the NFD findings of a patient with pharyngeal cancer, which was developed 2 years after the occurrence of NFD. The development of NFD in patient with alcohol and tobacco consumption should lead otolaryngologists and dermatologists to suspect head and neck malignancy. In cases of normal otolaryngological examination, patients have to be followed.

Laryngeal cancer

2021 ◽  
pp. 175573802110105
Author(s):  
Kelvin Miu
Keyword(s):  
Head And Neck Cancer ◽  
Early Diagnosis ◽  
Head And Neck ◽  
Patient Outcomes ◽  
Laryngeal Cancer ◽  
Neck Cancer ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Diagnosis And Treatment

Laryngeal cancer is a common head and neck cancer and typically presents with voice hoarseness in patients older than 60 years. Early recognition of signs and symptoms of laryngeal cancer can lead to early diagnosis and treatment, therefore improving patient outcomes. This article aims to provide an overview of the anatomy of the larynx, presentation and management of laryngeal cancer, and common follow-up problems.

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