Effects of a mobile oral care app on oral mucositis, pain, nutritional status, and quality of life in patients with head and neck cancer: A quasi‐experimental study

Abstract

Aim: The aim of this work is to explore the effectiveness of a mobile app to support oral mucositis care to improve the nutritional status and reduce the occurrence of oral mucositis of patients with head and neck cancer undergoing concurrent chemoradiotherapy.Background: Concurrent chemoradiotherapy is the optimal treatment for head and neck cancer, but oral mucositis and malnutrition are common complications.Design: Quasi-experimental study using a pre-post design was used in this work.Method: Participants were recruited from a major regional hospital in Taiwan from July 2018 to July 2020. There were 32 participants in each group: the mobile app group (Intervention Group) or routine care (Control Group). The primary outcome measure was Patient-Generated Subjective Global Assessment (PG-SGA). We also collected data on grade of oral mucositis, painNnumeric Rating Scale (NRS), weight loss, haemoglobin (Hb), albumin and quality of life (QoL). Result:The PG-SGA score was significantly lower in the intervention than the control group at all three time points. Hb and albumin decreased less significantly in the intervention than the control group after 2 months. The oral mucositis grade was significantly less severe in the intervention than the control group at all three time points; for the NRS, at T2 and T3. Conclusion:Using the mobile app effectively improved nutritional status, alleviated the side effects, and improved the QoL of head and neck cancer patients with concurrent chemoradiotherapy.

Evaluation of Mobile Health Technology Interventions for the Postdischarge Management of Patients With Head and Neck Cancer: Scoping Review

“…Lin et al [ 24 ] developed an oral care mobile app to provide medical health information and oral mucosal care advice to patients during radiotherapy for HNC. The results of the study showed that the Patient-Generated Subjective Global Assessment scores of the group using mHealth technology were significantly lower than those of the control group at all 3 nodes during the intervention.…”

“…Most studies (n=9, 69.2%) measured and evaluated the HRQoL. Of these, 6 (66.7%) studies [ 14 , 19 , 21 - 24 ] used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 35 and Head and Neck Module (EORTC-QLQ-H&N35), 2 (22.2%) studies [ 13 , 15 ] used the Functional Assessment of Cancer Therapy—Head and Neck (FACT-H&N) scale, 2 (22.2%) studies [ 16 , 19 ] used the HRQoL scale, and 1 (11.1%) study [ 17 ] used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and Provisional 25-item Information Module (EORTC-QLQ-INFO-25) to assess the QoL of survivors of HNC.…”

Effectiveness of Comprehensive Intervention Programme on Quality of life, fatigue, self-efficacy, and psychosocial distress among head and neck cancer patients receiving radiotherapy

“…Similar findings were identified in a study conducted by Lin et al, to assess the effectiveness of “mobile oral care app,” which had an educational content to improve QOL. The results of this study showed significant improvement in QOL among the participants of intervention group ( p < 0.001) [ 26 ]. The literature supports the benefits of exercise therapy and psychosocial programmes in improving the QOL among HNC patients [ 27 , 28 ].…”

Mobile Health System for Meeting Health Information Needs in Patients With Head and Neck Cancer Undergoing Radiotherapy

“…17 Mobile health provides patients with access to informative animations, healthcare knowledge, and a platform for communication, enabling repetitive learning. 18 The ideal mHealth will meet patients' needs and enhance convenience and efficiency in clinical settings. 19,20 However, to our knowledge, current applications of mHealth in HNC are mainly focused on remote triage, 21,22 disease detection, 23,24 and symptom management, 25,26 leaving patients' diverse needs unaddressed, including psychology, nutrition, and physical activity.…”

“…It has been widely used in oncology 17 . Mobile health provides patients with access to informative animations, healthcare knowledge, and a platform for communication, enabling repetitive learning 18 . The ideal mHealth will meet patients' needs and enhance convenience and efficiency in clinical settings 19,20 .…”