Dry mouth in palliative care: A systematic review of clinical practice guidelines around the world
Abstract
Background: Dry mouth is a disruptive symptom in patients with life-limiting illnesses. It has one of the highest symptom burdens in palliative care and a significant impact on quality of life. Nonetheless, dry mouth remains an underacknowledged and undertreated symptom with limited evidence-based interventions. Aim: To examine the quality and content of guidelines for the treatment of dry mouth in patients with life-limiting illnesses. Design: A systematic review of clinical practice guidelines was conducted (preregistered in PROSPERO in 2023). PRISMA reporting guidelines were followed. The search strategy involved 4 scientific databases and 9 guideline databases, targeted searches and stakeholder outreach for 183 countries/regions. Quality and content were analysed using the AGREE II instrument and directed content analysis, respectively. Data sources: Seventy-two clinical practice guidelines from 42 countries across 6 continents were included. Results: Only two guidelines were recommended for use based on the AGREE II quality appraisal. Four main themes emerged from the content analysis: (1) Assessment of dry mouth by medical history, oral examination and measuring instruments (n = 32, n = 36 and n = 19 guidelines respectively); (2) Oral care (n = 68); (3) Management by treating causes (n = 40), saliva substitutes (n = 66) and stimulants (n = 62), diet (n = 45), and medication (n = 40); and (4) Patient and family involvement (n = 43). Conclusion: Despite differences in…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 68 participants or records.
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