Self-management intervention improves patient adherence to swallowing exercises during radiation for head and neck cancer

Head Neck. 2024 Nov;46(11):2878-2889. doi: 10.1002/hed.27832. Epub 2024 Jun 14.

Abstract

Background: While preventive swallowing exercises reduce the risk of radiation-associated dysphagia in patients with head and neck cancer, strategies are needed to improve patient adherence.

Methods: Before radiation, all participants were taught preventive swallowing exercises and randomized to either an adherence intervention or enhanced usual care. During radiation, all participants met twice with a speech pathologist for swallowing assessment and reinforcement of exercises. Intervention participants met weekly with a counselor in-person or by phone. At 6-week post-radiation follow-up, all participants completed a follow-up assessment of self-reported adherence, which was then corroborated with medical record documentation.

Results: Newly diagnosed pharyngeal and laryngeal cancer patients without distant metastases were randomized (n = 265; 135 to intervention, and 130 to usual care). Intervention participants were more likely to adhere to exercises during radiation compared to the control group (p < 0.0001).

Conclusion: The weekly in-person adherence intervention program significantly increased patient's adherence to preventive swallowing exercises during radiation.

Keywords: adherence; coping; psychosocial; radiation; self‐management.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Deglutition
  • Deglutition Disorders* / etiology
  • Deglutition Disorders* / prevention & control
  • Exercise Therapy* / methods
  • Female
  • Head and Neck Neoplasms / radiotherapy
  • Humans
  • Laryngeal Neoplasms / radiotherapy
  • Male
  • Middle Aged
  • Patient Compliance*
  • Pharyngeal Neoplasms / radiotherapy
  • Radiation Injuries / prevention & control
  • Self-Management