Patterns of sore mouth in outpatients with cancer receiving chemotherapy.
OBJECTIVE
The aims of this secondary data analysis were to (a) categorize patterns in the development, duration, intensity, and resolution of sore mouth (which can be considered a proxy for oral mucositis) severity and distress over two cycles of chemotherapy in cancer outpatients and (b) examine the relationship of demographic (age, gender, marital status, and educational level) and disease characteristics (type of cancer and type of chemotherapy) to specific patterns of sore mouth (SM).


METHODS
Visual graphical analysis (VGA) was applied to identify individual patterns of SM severity and distress in 51 outpatients receiving chemotherapy who provided daily reports of sore mouth using a computerized interactive voice response system. The majority were female (n = 41, 8%) with a mean age of 53 (SD = 8.35). Most had breast cancer (68%), and one third received chemotherapy with adriamycin and cyclophosphamide (AC). VGA is a technique in which graphs of individual patients' symptoms are coded for specific individual or group profiles.


RESULTS
Seven distinct patterns were identified based on variability in onset, duration, and intensity (degree of severity or distress). Chemotherapy agents were significantly associated with patterns of SM. The AC regimen was significantly associated with late onset; however, the intensity did not last long. In contrast, patients receiving R-CHOP were significantly more likely to experience duration intensity (SM after day 15 and a score equal to or greater than a 5 on a 1-10 scale).


CONCLUSIONS
VGA revealed symptom patterns often hidden in traditional analysis. Understanding individual variability is important to the design and implementation of future intervention research and clinical care.
School Of Nursing, College of Health Sciences, University of Delaware, McDowell Hall, Newark, DE 19716, USA. carl@carltonbrown.org
Carlton G
CG
Brown
Susan L
SL
Beck
Douglas E
DE
Peterson
Deborah B
DB
McGuire
William N
WN
Dudley
Kathleen H
KH
Mooney
D000553:Ambulatory Care; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003196:Computer Graphics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012720:Severity of Illness Index; D013280:Stomatitis / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D017216:Telemedicine; D013997:Time Factors
D000970:Antineoplastic Agents