Laurelie R Wall1,2,3,4, Elizabeth C Ward1,3,4, Bena Cartmill1,2, Anne J Hill3,4, Elizabeth Isenring5, Joshua Byrnes6, Sandro V Porceddu7,8. 1. Centre for Functioning and Health Research, Queensland Health, Queensland, Australia. 2. Speech Pathology Department, Princess Alexandra Hospital, Queensland Health, Queensland, Australia. 3. School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia. 4. Centre of Research Excellence in Telehealth, The University of Queensland, Queensland, Australia. 5. Department of Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia. 6. Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Queensland, Australia. 7. Radiation Oncology Department, Princess Alexandra Hospital, Queensland Health, Queensland, Australia. 8. School of Medicine, The University of Queensland, Queensland, Australia.
Abstract
BACKGROUND:Intensive prophylactic swallowing therapy can mitigate dysphagia in patients with oropharyngeal (OP) SCC, however, presents service challenges. This trial investigated the clinical efficacy of three service models delivering prophylactic swallowing therapy during (chemo)radiotherapy ([C]RT). METHODS:Patients (n = 79) with OPSCC receiving (C)RT were were randomized to: (a) clinician-directed face-to-face therapy (n = 26); (b) telepractice therapy via "SwallowIT" (n = 26); or (c) patient self-directed therapy (n = 27). Swallowing, nutritional, and functional status were compared at baseline, 6-weeks, and 3-months post-(C)RT. Patients' perceptions/preferences for service-delivery were collated posttreatment. RESULTS: Service-delivery mode did not affect clinical outcomes, with no significant (P > .05) between-group differences or group-by-time interactions observed for swallowing, nutrition, or functional measures. Therapy adherence declined during (C)RT in all groups. SwallowIT and clinician-directed models were preferred by significantly (P = .002) more patients than patient-directed. CONCLUSIONS: SwallowIT provided clinically equivalent outcomes to traditional service models. SwallowIT and clinician-directed therapy were preferred by patients, likely due to higher levels of therapy support.
RCT Entities:
BACKGROUND: Intensive prophylactic swallowing therapy can mitigate dysphagia in patients with oropharyngeal (OP) SCC, however, presents service challenges. This trial investigated the clinical efficacy of three service models delivering prophylactic swallowing therapy during (chemo)radiotherapy ([C]RT). METHODS:Patients (n = 79) with OPSCC receiving (C)RT were were randomized to: (a) clinician-directed face-to-face therapy (n = 26); (b) telepractice therapy via "SwallowIT" (n = 26); or (c) patient self-directed therapy (n = 27). Swallowing, nutritional, and functional status were compared at baseline, 6-weeks, and 3-months post-(C)RT. Patients' perceptions/preferences for service-delivery were collated posttreatment. RESULTS: Service-delivery mode did not affect clinical outcomes, with no significant (P > .05) between-group differences or group-by-time interactions observed for swallowing, nutrition, or functional measures. Therapy adherence declined during (C)RT in all groups. SwallowIT and clinician-directed models were preferred by significantly (P = .002) more patients than patient-directed. CONCLUSIONS: SwallowIT provided clinically equivalent outcomes to traditional service models. SwallowIT and clinician-directed therapy were preferred by patients, likely due to higher levels of therapy support.
Authors: Alana R Hutchison; Laurelie R Wishart; Bena Brown; Elizabeth C Ward; Catriona Hargrave; Elizabeth Brown; Sandro Porceddu Journal: Dysphagia Date: 2021-05-08 Impact factor: 3.438
Authors: M M Khan; B Manduchi; V Rodriguez; M I Fitch; C E A Barbon; H McMillan; K A Hutcheson; R Martino Journal: BMC Health Serv Res Date: 2022-09-30 Impact factor: 2.908
Authors: Jung Julie Kang; Richard J Wong; Eric J Sherman; Alisa Rybkin; Sean M McBride; Nadeem Riaz; C Jillian Tsai; Yao Yu; Linda Chen; Kaveh Zakeri; Daphna Y Gelblum; Erin F Gillespie; Marc A Cohen; Jennifer R Cracchiolo; Ian Ganly; Snehal Patel; Bhuvanesh Singh; Jay O Boyle; Benjamin R Roman; Luc G Morris; Ashok R Shaha; Lara A Dunn; Alan L Ho; James V Fetten; Jatin P Shah; David G Pfister; Nancy Y Lee Journal: Cancer Date: 2020-07-08 Impact factor: 6.921