Comfortable Mouths in Terminal Phase of Life: A Feasibility Study for Managing Xerostomia in Hospice Patients

Background/aims: Dry mouth is prevalent in > 80% of hospice patients and affects quality of life. A fytotherapeutic Dexpanthenol gel was developed with hospice patients to address their needs. Aim: assess the feasibility of future trial procedures for comparing Dexpanthenol with an OTC substitute for managing xerostomia. Methods: Mixed method cross sectional feasibility study in the hospice setting. Patients aged > 18, with dry mouth, Utrecht Symptom Diary (USD) score > 0 and willing to try Dexpanthenol were eligible. For 5 days, patients were asked to complete 3 questionnaires daily, before and after gel application. Primary outcomes: 1) 2) enrollment rate, attrition rate, data completeness, perceived feasibility of procedures by caregivers and patients. Secondary outcome: difference in dry mouth as measured by the USD. Qualitative data consisted of a focus group interview and was thematically analyzed. Analysis of quantitative data included descriptive statistics and examination of withinpatient differences using the Students T-test. Results: 6 Dutch hospices participated for 6 months. 28 patients enrolled, 12 completed the study, attrition rate 57%. Most dropouts (N=12) occurred after 2 days. Two dropped out after inclusion. In total, 210 questionnaires of 26 patients were completed (54%). Caregivers (N=17) found the study protocol clear (N=11), partially clear (N=6) and integration into daily tasks feasible (N=13). Some faced recruitment challenges (N=5). Patients (N=7) found the study information clear and sufficient (N=6), 2 found participation burdensome, 6 wished to keep using the gel. A mean reduction of 3.2 (SD 2.33) was observed for dry mouth (p<.001). Qualitative analysis revealed patient burden, gatekeeping, and researcher involvement as key elements affecting feasibility. Conclusions: Consistent communication with hospice teams, shorter study duration, and addressing gatekeeping as a potential barrier are vital for study continuity. Further validation of Dexpanthenol in relieving dry mouth is required.