Assessment and management of oral mucositis :a hospital protocol -

Abstract

Oral mucositis is a common side effect of all cancer treatments including antineoplastic drugs, radiation therapy, and bone marrow transplantation, among others with high prevalence. Its impact on the population is linked with severe pain, decreased oral intake, delay in treatment, increased hospital stay, increased cost, decrease in the efficacy of treatment and decreased survival rate. The purpose of this project was to review the available literature on the assessment and treatment of oral mucositis and develop a protocol that can be followed with patients admitted to the American University of Beirut Medical Center who are undergoing cancer treatment.A thorough search was performed through the databases Academic Search Complete, MedLine and CINAHL to find protocols used to assess and treat oral mucositis in cancer patients and research studies on the topic. The key terms used for this search were: “oral mucositis”, “protocol”, “guideline”, “cancer”, and “cancer patients”. All articles presenting methods for prophylaxis against, prevention or management of oral mucositis were included. Articles were excluded if they addressed other muscositis such as GI mucositis.Two main guidelines identified were developed by the Oncology Nursing Society in 2009 and the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology, last updated in 2014. Moreover a few recent studies were found. Many of the recommendations are not based on the strongest level of evidence, due to the lack of randomized trials and inconsistent results of studies. Based on the literature, the protocol developed involved an assessment tool to identify the stage of oral mucositis, and a treatment algorithm targeting each stage. A documentation of form for the protocol was also prepared. Plans for protocol implementation and evaluation plan for the protocol are proposed. The role of the advanced practice nurse in implementation and monitoring proto