Increase in pretreatment evaluations and in the rate of referral; reduction in feeding tube placement
THURSDAY, April 26, 2018 (HealthDay News) — A proactive speech and language pathology (SLP) program is beneficial for patients with head and neck squamous cell carcinoma (HNSCC), according to a study published online April 19 in JAMA Otolaryngology-Head & Neck Surgery.
Guarav S. Ajmani, M.H.S., from the University of Chicago, and colleagues examined the initiation of a proactive SLP rehabilitation program for patients with HNSCC in 2011. Patients were divided into two groups: 2004 to 2010 (before program implementation; 135 patients) and 2011 to 2015 (after program implementation; 119 patients).
The researchers found that there was an increase in pretreatment evaluations from 21.5 to 58.8 percent with the initiation of a proactive SLP program (risk ratio, 2.74) and an increase in the rate of referral overall at any time from 60 to 79.8 percent (risk ratio, 1.33). A decrease was seen in feeding tube placement rates, from 45.9 to 29.4 percent (risk ratio, 0.64). Among patients receiving a swallow evaluation, feeding tube requirements were less frequent for those receiving a pretreatment evaluation compared with referral during or after treatment (31 percent versus 61 and 64 percent, respectively). There was improvement in the rate of tolerating any oral intake at the end of treatment, from 71.1 to 82.4 percent (risk ratio, 1.16).
“A proactive SLP program can be successfully established as part of the multidisciplinary care of patients with HNSCC and improve patient quality of life,” the authors write.
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