CONTINUING OUR BERLIN POSTERS SERIES …
Poster presentations are an essential cornerstone of every EAPC Congress – this year at the 16th EAPC World Congress in Berlin more than 1,100 posters were on display representing the scientific rigour and commitment of people involved in palliative care from across the world.
Ragnhild E Monsen, RN, MSc, tells us more about the award-winning poster that she and her fellow researchers from Lovisenberg Diaconal Hospital and the Faculty of Dentistry at the University of Oslo, Norway, presented in Berlin.
We were delighted to win first prize in the poster awards at the EAPC World Congress in Berlin 2019 for our research on oral health: A comparison of normal saline mouthwash and mouthwash based on a tea solution from Salvia officinalis in palliative care: A Randomized Controlled Trial. We were also grateful on behalf of all the patients who participated, many of whom wished to contribute to the improvement of end-of-life care by taking part in this study.
Oral discomfort is common in palliative care patients. Despite its high prevalence, poor oral health among cancer patients, particularly those receiving palliative care, has been a neglected aspect of patient care and research. In the Hospice unit at Lovisenberg Diaconal Hospital, the nursing staff have long recognised oral discomfort and dry mouth as one of the most reported and distressing symptoms. Searching for different products and treatments, they discovered an oncology centre in Tübingen,Germany, where the herbal Salvia Officinalis (SO) was used as a mouth rinse to treat adverse effects of radiotherapy in the oral cavity for head and neck cancer patients. SO has a long history in natural medicine. Along with its other uses, SO may also be beneficial for oral discomfort, given its possible anti-inflammatory, antiseptic and metabolism regulation properties. Most of the patients and the clinicians in the unit experienced SO to be a helpful product in the oral care regimen, but there was no evidence to recommend SO for this purpose.
Despite the complexity of oral problems among patients in palliative care, cooperation between dental care professionals and clinicians in clinical practice is rare. At the Faculty of Dentistry at the University of Oslo, they have the clinical and scientific experience for understanding and managing oral health issues in cancer treatment. In 2008, a Faculty research group included the Hospice unit in a cross-sectional survey (1). In preparation for our randomised controlled study (RCT), this was a golden opportunity to resume an interdisciplinary cooperation. Three dentists were involved in the research group and this cooperation resulted in good discussions about assessment tools, professional knowledge of oral health, and experiences of different treatments in end-of-life care. It was important to include staff with extensive experience with this patient group, in order to develop a procedure that both minimisedthe burden on patients and was feasible for the nursing staff that had to administer the intervention.
We conducted an RCT and included 88 patients from 2014 to 2016. The patients followed standard recommended oral care, brushing their teeth morning and evening. They also rinsed their mouth four times a day for four days. There were no differences between the group who used SO and the group rinsing with normal saline. However, there were statistically significant improvements in both groups on patient-reported outcome measures and clinical examinations performed by the dentists.
The implications for practice are that systematic assessment and treatment improve oral health in palliative care significantly, and systematic multidisciplinary collaboration should be a goal for the further work of oral health in palliative care.
- Wilberg P, Hjermstad MJ, Ottesen S, Herlofson BB. Oral health is an important issue in end-of-life cancer care. Supportive Care in Cancer. 2012;20 (12):3115-22.
Members of the research group
Ragnhild Elisabeth Monsen, Caryl Gay, Elisabeth Saghaug, Joran Slaaen, Tone Sundal and Anita Tollisen, Lovisenberg Diaconal Hospital, Oslo, Norway.
Bente Brokstad Herlofson, Unit of Oral and Maxillofacial Surgery, Department of Otorhinolaryngology – Head and Neck Surgery Division for Head, Neck and Reconstructive Surgery, Oslo University Hospital, Oslo,NorwayLene Hystad Hove, Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Norway.
Katrine Gahre Fjeld, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Norway.
Anners Lerdal, Lovisenberg Diaconal Hospital and Department of Interdisciplinary Health Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway.
- Read the abstract of A comparison of normal saline mouthwash and mouthwash based on a tea solution from Salvia officinalis in palliative care: A Randomized Controlled Trial. Poster P02-144, (Monsen R, Herlofson BB, Gay C, Fjeld KG, Hove LH., Saghaug E, Slaaen J, Sundal T, Tollisen A, Lerdal A). (All abstracts are published in Palliative Medicine May 2019.
- View and download the ePosters from EAPC World Congress in Berlin.
- Next week’s post in the Berlin Posters series is by Mhoira Leng, Vicky Opia and Julia Downing – read this and more posts relating to the 16th EAPC World Congress on the EAPC blog.
- Contact Ragnhild E. Monsen by email.
- Lovisenberg Diaconal Hospital website.
- Online abstract submission for #EAPC2020 now open!
- Visit the congress website for more information on the 11th EAPC World Research Congress, Palermo, Italy – 14 to 16 May 2020. Submit your abstract now. (Closing date: 15 October 2019.