Implementation of the "l'O à la bouche" Therapeutic Patient Education Program at a French Cancer Center: A Multidisciplinary Approach for Managing Post-Cancer Oral Toxicities.

Abstract

Head and neck cancer treatments, particularly radiotherapy, cause significant oral toxicities that profoundly impact patients' quality of life, including salivary modifications, swallowing disorders, and the risk of osteoradionecrosis. While therapeutic patient education (TPE) programs exist for various chronic conditions, there remains a notable gap in specific programs addressing oral complications in head and neck cancer patients. This article describes the development and implementation of the innovative TPE program "l'O à la bouche" at a French cancer center, specifically designed for head and neck cancer patients experiencing post-treatment oral toxicities. A multidisciplinary working group was established, including ENT surgeons, speech-language pathologists, dietitians, radiotherapy technicians, nurses, dentists, psychologists, and patient partners. The program development followed a structured timeline from February 2020 to June 2021. The program comprises four complementary workshops addressing oral physiology modifications, safety and self-monitoring for aspiration risks, practical self-care skills, and psychosocial rehabilitation. The program obtained official authorization in December 2020 and began implementation in June 2021, with stable activity of 12 workshops annually, accommodating 5 to 8 patients per workshop. This initiative addresses a previously unmet national need, as no equivalent TPE programs existed specifically targeting salivary modifications and their oral consequences in head and neck cancer patients. The strong involvement of patient partners throughout all development phases ensures clinical relevance and patient-centered care. This program serves as a model for specialized therapeutic education that can improve patient self-management skills, enhance treatment adherence, and ultimately optimize quality of life through targeted patient education interventions.