Systematic Review of Adherence to Swallow and Trismus Exercises During Radiation Therapy for Head and Neck Cancer
Head & Neck
Charters, E., Ricketts, V., et al. (2024).
Head & Neck, Advance online publication. https://doi.org/10.1002/hed.27849.
<div>This systematic review investigates the facilitators and barriers to completing swallow and trismus treatment and the effects of treatment adherence on outcomes in individuals with head and neck cancer.</div>
Cancer Institute New South Wales (Australia); Sydney Local Health District (Australia); Lang Walker Family Foundation (Australia); Chris O'Brien Lifehouse Surfebruary Research Seed Funding; Australia and New Zealand Head and Neck Cancer Society; Royal Australasian College of Surgeons
From database inception to July 2023
<div>Peer-reviewed qualitative and quantitative studies</div>
20
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<div>Two studies reported positive associations between swallowing treatment adherence and improved swallowing outcomes in patients with head and neck cancer.</div>
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<div>Limitations of this review include a lack of meta-analysis and the inability to verify patient-reported adherence. Additional research is needed to investigate optimal exercise regimens for head and neck cancer patients.</div>
<div>Nine studies found no association between treatment adherence and trismus outcomes in patients with head and neck cancer.</div>
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<div>Limitations of this review include a lack of meta-analysis and the inability to verify patient-reported adherence. Additional research is needed to investigate optimal exercise regimens for head and neck cancer patients.</div>
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<div>Facilitators to swallow and trismus treatment adherence in patients with head and neck cancer include the following:</div>
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<ul>
<li>regular appointments with a multidisciplinary team;</li>
<li>individualized, clear, and accessible information;</li>
<li>social support;</li>
<li>goal-setting and motivation;</li>
<li>perceived benefits and fear of regression;</li>
<li>support for managing radiation;</li>
<li>clinician-patient relationship; and</li>
<li>applications or mobile technology supports.</li>
</ul>
<div>Barriers to swallow and trismus treatment adherence in patients with head and neck cancer include the following:</div>
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<ul>
<li>radiation toxicities and decreased physical conditions;</li>
<li>anxiety, worry, memory loss, fatigue, and panic attacks;</li>
<li>poor motivation or lack of improvement;</li>
<li>information overwhelm and time burden;</li>
<li>technical burdens;</li>
<li>not understanding the exercises; and</li>
<li>proximity to a treatment facility.</li>
</ul>
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<div>Limitations of this review include a lack of meta-analysis and the inability to verify patient-reported adherence. Additional research is needed to investigate optimal exercise regimens for head and neck cancer patients.</div>
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