A Novel Approach to Managing Thirst and Dry Mouth in Palliative Care: A Prospective Randomized Cross-Over Trial

• Published in: Journal of pain and symptom management Vol. 66; no. 5; pp. 587 - 594.e2
• Main Authors: Phelan, Caroline, Hammond, Lauren, Thorpe, Courtney, Allcroft, Peter, O'Loughlin, Muireann
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2023
• Subjects: end-of-life; oral care; palliative; Thirst; xerostomia; CONSORT; RCT; palliative; oral care; end-of-life; CLT; IQR; NRS; Nu-DESC; SD; AKPS; NBM; ICU; xerostomia; SPSS; Thirst
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2023.08.005

Thirst and xerostomia are significant and highly distressing symptoms experienced by patients receiving palliative and end-of-life care. Determine a reduction of thirst intensity and perceptions of dry mouth on a numerical scale following both the experimental intervention (mini mint ice cubes) and control (plain ice chips). Cross-over Randomized Controlled Trial (RCT) to assess the effectiveness of novel intervention in the treatment of dry mouth and the sensation of thirst in palliative care patients. Patients rated the severity of their symptoms of dry mouth and thirst using a numeric rating scale (NRS). On commencing the study and preintervention, all patients suffered severe dry mouth and thirst (≥5/10). Mint and plain ice cubes produced improvement of symptoms immediately after interventions. Results from dry mouth ratings show, a decrease of 1.6 points for plain ice cubes (P < 0.0001), on average, ratings for mint ice cubes decreased 3.7 (P < 0.0001). For the sensation of thirst, the plain ice cube intervention group rating decreased 1.7 points (P < 0.006), ratings for mint ice cubes decreased 3.4 points (P < 0.0001). The average decrease in dry mouth and thirst intensity scores from preintervention to postintervention were significantly greater for mint ice cubes (P < 0.05) and 86.6% of patients preferred mint ice cubes. This trial found that while usual mouth care and the intervention were both able to reduce the intensity of dry mouth and the sensation of thirst, the mint intervention had a greater response.