Audit of the treatment provision for head & neck cancer patients
Head and neck cancer patients are referred to the Dublin Dental School & Hospital for pre-radiotherapy dental assessment and treatment. We examined (a) length of time between referral and assessment, (b) attendance patterns, (c) treatment required, (d) if treatment was completed. Methods: The charts and computer records of sixty-eight patients, who had their initial assessment prior to June 2004, were analysed. Results: 100% of patients attended for baseline assessment and had 2-16 appointments. 46% were assessed within one week of referral and 86% within two weeks. 59% of appointments were attended, 18% were cancelled by the patient, 10% were cancelled by the Hospital and patients did not attend for 14%. Treatment plans revealed that 96% of patient’s required oral hygiene instruction, scaling, fluoride therapy and one-year review. 70% needed one or more dental extractions and 46% required restorative care. 54% of treatment plans had been completed within one year. Of the 46% whose treatment was not completed, 33% had not returned for review and 33% did not have restorative care completed in the Dental Hospital. Discussion: This audit shows that all patients attended for baseline assessment and the majority of patients are assessed within two weeks. 67 patients had the planned pre-radiation dental extractions. 15% of patients did not receive the planned restorative treatment – patients are advised to attend their GDP for non-urgent restorative care. 15% did not have a review – this group of patients are commonly symptomatic dental attendees who smoke and drink, often requiring several phone calls to arrange appointments. Patients do tend to return for their oncology/surgical reviews. Conclusions: Patients should receive a written treatment plan (copied to their GDP when possible). Manpower is needed for oral health education and ongoing supportive therapy, especially in the surgical/oncology unit to optimise on patient attendance. A co-ordinator is needed to monitor appointments and arrange follow-up.