Comparing dysphagia therapy in head and neck cancer patients in Australia with international healthcare systems

Abstract

By comparing the results of this survey with existing international best-evidence treatment guidelines, the development of uniform Australian guidelines may be facilitated. However, more authoritative data on dysphagia treatment efficacy is needed to provide uniform evidence-based HNC dysphagia treatment guidelines.

Speech‐language pathology care and short‐ and long‐term outcomes of oropharyngeal cancer treatment in the elderly

“…Such institutions are usually on the forefront of new thinking and may be more familiar with the evidence in favor of routine SLP involvement, with improved access. The limited number of studies summarized above with small participant numbers and variations in outcomes methodology have led a call for more evidence to inform practice …”

“…The limited number of studies summarized above with small participant numbers and variations in outcomes methodology have led a call for more evidence to inform practice. 38 There are limitations to the use of Medicare data in risk adjustment and documentation that may impact the observed differences in survival based on quality of care and outcomes. Poor outcomes may reflect differences in processes of care, or may reflect unobserved patient severity or severity of toxicities not captured by administrative data.…”

Dysphagia and related toxicity in patients with head and neck cancer receiving helical intensity modulated radiotherapy +/- chemotherapy: Implications for speech pathology management

“…Of those, 26% saw patients weekly, 3% fortnightly and 46% on request. In contrast, 57% of Australian cancer care centres reported seeing patients, often in conjunction with a dietitian, weekly during treatment as well as providing post-treatment management (Lawson et al, 2017;Lawson & Ward, 2014;Maclean et al, 2013;Wall, Cartmill, Ward, Hill, Isenring, & Porceddu, 2016). These services are generally provided as a "one-size-fits-all" service delivery model and do not account for the specific needs of subgroups of HNC patients.…”

“…Therefore, based on the results of Chapter 4, in Chapter 5 the outcomes of an alternative interdisciplinary service delivery model, developed in conjunction with the dietetics service is The lack of clear evidence of differential patterns of need, and lack of published guidelines for care, has contributed to differences in service delivery models internationally, with wide variations noted in the intensity and timing of SP care provided to HNC patients (Krisciunas et al, 2012;Roe et al, 2012). In Australia, 57% of cancer care centres reported seeing patients weekly during RT and providing post-treatment management, frequently in conjunction with a dietitian (Lawson et al, 2013;Lawson & Ward, 2014;Maclean et al, 2013;Wall, Cartmill, Ward, Hill, Isenring, & Porceddu, 2016). This weekly service delivery model is currently used at the study institution for all patients with HNC undergoing RT with or without chemotherapy.…”

“…In Australia it is common practice for cancer centres to have dedicated speech pathologists within their multidisciplinary HNC teams (Lawson, Langmore, Krisciunas, & Sokoloff, 2013;Lawson & Ward, 2014;Maclean, Ward, Findlay, & Rees, 2013), typically providing pre-treatment intervention, weekly reviews during treatment to all HNC patients, and ongoing follow up post-treatment as required in conjunction with dietetic services (Lawson et al, 2013). The same intensity of SP care is generally provided to all HNC patients undergoing (C)RT regardless of differences in diagnosis or treatment plan.…”