Chronic Adherence to Heat and Moisture Exchanger Use in Laryngectomized Patients

Pedemonte-Sarrias, Gabriel; Villatoro-Sologaistoa, Juan Carlos; Ale-Inostroza, Paulina; López-Vilas, Montserrat; León-Vintró, Xavier; Quer-Agustí, Miquel

doi:10.1016/j.otoeng.2013.08.007

Cited by 8 publications

(6 citation statements)

References 18 publications

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Section: Discussionmentioning

confidence: 99%

“…In addition, skin irritation was less frequent with the NG adhesives, which may have contributed to the increased adherence to HME use. These findings are clinically important because HME removal due to shortness of breath 12,20,26 and skin irritation due to the adhesives 28,29,30,49 are considered the main causes of pulmonary rehabilitation failure. 4,13 Although previous clinical studies on HME users have established a connection between adherence to 24/7 HME use and improved quality of life, 6 EQ-5D scores in the current study were better during use of NG products than during UC but not pulmonary health.…”

Section: Discussionmentioning

confidence: 99%

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Optimizing Pulmonary Outcomes After Total Laryngectomy: Crossover Study on New Heat and Moisture Exchangers

Longobardi

Galli

Cesare

et al. 2022

Otolaryngol.--head neck surg.

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Objective To evaluate the effects of new devices—heat and moisture exchangers (HMEs) and adhesives—on pulmonary symptoms, subject adherence, quality of life, dermatologic symptoms, and patient satisfaction after laryngectomy. Study Design Prospective crossover study. Setting Between December 2020 and April 2021, 40 patients were enrolled who had undergone laryngectomy, routinely used HMEs and adhesive, and were followed in our Department of Otolaryngology–Head and Neck Surgery. Methods Patients were allocated into group A (new products) or group B (usual care) for 6 weeks. Then the 2 groups reversed, and each patient acted as his or her own control. Patients kept a diary and cough tally sheet. At baseline and after each 6-week period, 2 questionnaires were administered: EQ-5D (European Quality of Life–5 Dimensions) and CASA-Q (Cough and Sputum Assessment Questionnaire). Results Six weeks of using new products resulted in the following effects for both groups: (1) a significant reduction in daily forced expectoration and dry coughs, (2) a significant improvement in all domains of the CASA-Q, (3) an increase in adherence to HME use, (4) a significant reduction in shortness of breath and skin irritation, and (5) significantly better scores in the anxiety/depression domain of the EQ-5D. Conclusion Achieving this reduction in patients who were already highly adherent to HME use is clinically relevant and underscores the importance of using better-performing HMEs that can compensate for the humidification deficit. Improving pulmonary symptomatology could reduce patient restrictions in daily life and avoidance of social activity, with a consequent positive effect on quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Optimizing Pulmonary Outcomes After Total Laryngectomy: Crossover Study on New Heat and Moisture Exchangers

Longobardi

Galli

Cesare

et al. 2022

Otolaryngol.--head neck surg.

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“…A recent Spanish study showed that 78% of laryngectomised patients that were prescribed HMEs used the HME consistently, while 22% abandoned its use despite the well‐known beneficial effects of HME use. The most common causes of desertion were adhesion problems due to mucus and skin irritation . Van der Houwen et al .…”

mentioning

confidence: 99%

Patients' experiences withHMEs and attachments after total laryngectomy

Macrì

Bogaardt

Parrilla

et al. 2016

Clinical Otolaryngology

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“…The 43% (n = 20) who were indicated not to further use it mentioned that they perceived no advantages or that they disliked changing the adhesive more often. Difficulty in and issues with frequency of replacement have been described in several other HME studies …”

Section: Discussionmentioning

confidence: 79%

“…This allowed for better characterization of compliance outcomes. Historically, there has been variability in the definition of compliant or adherent use . This may have contributed to large range of reported noncompliance rates in using HMEs from 48% to 82% of subjects .…”

Section: Discussionmentioning

confidence: 99%

Multicenter randomized crossover trial evaluating the provox luna in laryngectomized subjects

et al. 2019

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ObjectivesThe aim of this study was to compare the relative compliance and the dermatological and pulmonary outcomes when the Provox Luna system (Atos Medical, Malmö, Sweden) is added during the night to the usual tracheastoma care of laryngectomized subjects.MethodsThis was a multicenter randomized crossover trial conducted in the Netherlands Cancer Institute, Erasmus Medical Center, and Maastricht University Medical Center in The Netherlands. The study included 46 laryngectomized subjects with prior heat and moisture exchanger (HME) and adhesive experience.ResultsA significant improvement in the number of compliant individuals was found: Luna: n = 43 of 45 (96%); usual care: n = 35 of 46 (76%), P = 0.02. The Luna period was associated with longer intervals of daily HME use (Luna 23.2 hours [range: 15.6–24.0 hours], usual care [UC]: 21.5 hours [range: 6.0–24.0 hours], P = 0.003) and an increased frequency of skin improvement overnight (Luna 3.9 days [standard deviation (SD)]: 7.0 days), Usual Care: 8.1 days ([SD: 10.8 days], P = 0.008). Fifty‐six percent (n = 26) of participants wanted to continue using the Provox Luna system at the conclusion of the study.ConclusionAn improvement in compliance and skin recovery overnight was observed when the Provox Luna was added to the usual adhesive and HME use. Therefore, there is utility in supplementing the usual post‐total laryngectomy care with the Provox Luna system at night, particularly in the setting of compliance concerns and in subjects who desire dermatological relief overnight.Level of Evidence1b Laryngoscope, 129:2354–2360, 2019

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Chronic Adherence to Heat and Moisture Exchanger Use in Laryngectomized Patients

Cited by 8 publications

References 18 publications

Optimizing Pulmonary Outcomes After Total Laryngectomy: Crossover Study on New Heat and Moisture Exchangers

Optimizing Pulmonary Outcomes After Total Laryngectomy: Crossover Study on New Heat and Moisture Exchangers

Patients' experiences withHMEs and attachments after total laryngectomy

Multicenter randomized crossover trial evaluating the provox luna in laryngectomized subjects

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