Clinical Practices in Head and Neck Cancer: A Speech-Language Pathologist Practice Pattern Survey

Area of Science:

• Speech-Language Pathology
• Oncology
• Clinical Practice Research

Background:

• Clinical practices for head and neck cancer (HNC) patients vary among speech-language pathologists (SLPs).
• Literature increasingly supports evidence-based best practices for HNC treatment.
• A gap exists between research evidence and clinical implementation.

Purpose of the Study:

• To identify current clinical practice patterns of SLPs treating HNC patients.
• To assess for discrepancies in the implementation of research evidence.
• To evaluate trends and associations in SLP clinical decision-making for HNC care.

Main Methods:

• A web-based survey was distributed to SLPs through professional networks.
• Descriptive statistics and group calculations were used to analyze survey responses.
• 152 surveys were collected and analyzed to identify trends in clinical practices.

Main Results:

• High consensus was found for prophylactic exercise programs (95%), SLP intervention during HNC treatment (75%), and post-treatment maintenance programs (97%).
• No consensus existed for pre-treatment swallow evaluations, service frequency, or therapy session content.
• Clinical decisions regarding feeding tubes and "nothing by mouth" status varied, with no association to experience or practice setting.

Conclusions:

• Wide variation in SLP clinical practices for HNC patients leads to inconsistent care.
• Compared to previous data, there is improved adherence to best practices for early referrals and prophylactic interventions.
• Continued efforts are needed to bridge the gap between evidence-based guidelines and clinical application in HNC treatment.