School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, NR4 7TJ, UK.
Support Care Cancer. 2011 Sep;19(9):1335-41. doi: 10.1007/s00520-010-0953-3. Epub 2010 Jul 31.
The aim of this study is to review current oral care practices in children being treated for cancer against audit criteria derived from national guidelines, and to compare findings with data from a baseline survey carried out in 2002 prior to implementation of the national guidelines.
A telephone survey was carried out of all 21 haematology-oncology (HO) centres and seven bone marrow transplant (BMT) units within the UK Children's Cancer Study Group focusing on key audit themes of: availability of evidence-based guidelines, oral and dental care prior to and during cancer treatment, oral assessment, prevention and treatment of oral complications.
The national guidelines were used in 19/25 (76%) settings that employed written guidelines. There was little variation in advice given to patients/parents on basic oral hygiene, and this advice was commensurate with guideline recommendations. Inconsistencies in oral care assessment, reported at baseline, remained commonplace across the majority of settings. In only 10/21 HO centres, it was usual practice for children to undergo dental assessment prior to commencing cancer treatment, indicating no improvement since baseline survey. Few therapies outside of the guideline recommendations were being used. The routine use of preventive nystatin, not recommended in the guideline, had significantly decreased from baseline (by 40%).
Uptake of national guidelines by HO/BMT settings was good however certain oral care practices fell short of the guideline recommendations. Routine dental checks need to be embedded in practice. Further consideration is needed as to how oral assessment might be used more effectively in informing treatment.
本研究旨在根据国家指南的审计标准，审查正在接受癌症治疗的儿童的口腔护理现状，并将研究结果与 2002 年在实施国家指南之前进行的基线调查数据进行比较。
对英国儿童癌症研究组的 21 个血液肿瘤学（HO）中心和 7 个骨髓移植（BMT）单位进行了电话调查，重点关注以下关键审计主题：是否有基于证据的指南、癌症治疗前后的口腔和牙齿护理、口腔评估、口腔并发症的预防和治疗。
19/25（76%）个使用书面指南的机构采用了国家指南。对患者/家长进行基本口腔卫生的建议基本一致，且与指南建议相符。在基线调查中报告的口腔护理评估不一致的情况，在大多数机构中仍然很常见。只有 10/21 个 HO 中心常规在开始癌症治疗前对儿童进行牙科评估，表明自基线调查以来没有改善。除了指南推荐的治疗方法之外，很少有其他治疗方法被使用。常规使用指南不推荐的预防性制霉菌素，与基线相比显著减少（减少了 40%）。
HO/BMT 机构对国家指南的采纳情况良好，但某些口腔护理做法不符合指南建议。常规的牙科检查需要纳入实践。需要进一步考虑如何更有效地利用口腔评估来指导治疗。
