Evaluation of the head and neck cancer patient concerns inventory in a cohort of patients attending routine multidisciplinary speech and language therapy/dietitian follow up clinics

Background: Speech and language therapy (SLT) and Dietetics follow up clinics following head and neck cancer (HNC) treatment are an integral part of multidisciplinary support. The use of a condition specific prompt list can help patients to raise issues, that otherwise might be missed. The objective of the present study was to evaluate the Patient Concerns Inventory -Head and Neck (PCI-HN) in a combined SLT/ dietitian (Diet) clinic, as an adjunct to routine care. Methods: This prospective observational study recruited patients from 30th January 2019 to 19th March 2020 across one trust involving two SLTs and two Diets. Patients completed the PCI-HN and a single quality of life (QOL) question prior to their consultation. Results: Ninety-four patients were recruited from a sample of 100 consecutive patients, and they first used the PCI-HN at a median (IQR) of 2.4 (1.3-7.1) months after the end of treatment. The PCI-HN was used more than once by 65 patients. When first used, the most common selections were dry mouth (62%), chewing/eating (55%), mucus (44%), swallowing (41%), appetite (35%), fatigue/tiredness (34%), energy levels (33%), coughing (28%), weight (28%), speech/voice/being understood (27%) and taste (27%). PCIHN items varied by tumour site, overall clinical stage, and primary treatment. Ninety one percent (32/35) of patients said the PCI-HN "definitely" helped communication with the clinician and 83% (29/35) "definitely" wanted to continue using it. Conclusions: Our preliminary data suggest that the PCI-HN is suitable for use in routine clinical practice in combined SLT and Diet clinics, as an adjunct to routine care. It enabled a patient led approach to the consultation, addressing concerns, and identifying interventions to support patients through their recovery. Early detection of issues which impact on eating, drinking and communication, allows the opportunity for the identification, and provision, of Speech and Language Therapy and Dietetic interventions, which can aid adaption, and ultimately, promote better outcomes.