Supportive Care in Cancer

, Volume 20, Issue 8, pp 1771–1777 | Cite as

Perspectives toward oral mucositis prevention from parents and health care professionals in pediatric cancer

  • Marie-Chantal Ethier
  • Dean A. Regier
  • Deborah Tomlinson
  • Peter Judd
  • John Doyle
  • Adam Gassas
  • Ahmed Naqvi
  • Lillian SungEmail author
Original Article



The objectives of this study were: (1) to describe parents and health care professionals (HCPs) perceived importance of oral mucositis prevention in children with cancer; (2) To describe utilities and willingness-to-pay (WTP) to prevent mucositis.


Respondents included parents of children receiving intensive chemotherapy for leukemia/lymphoma or undergoing stem cell transplantation and HCPs caring for children with cancer. Importance of mild and severe oral mucositis was estimated using a visual analogue scale (VAS). Mucositis-associated utilities were elicited using the time trade-off technique (TTO). WTP to avoid mucositis was obtained using contingent valuation. These techniques quantify how much time or money the participant is willing to relinquish in order to prevent mucositis.


Eighty-two parents and 60 HCPs were included. Parents and HCPs believed mild mucositis to be of similar importance (median VAS 2.5 versus 3.6; P = 0.357) while parents considered severe mucositis less important than HCPs (median VAS 8.3 versus 9.0; P < 0.0001). No differences in parent versus HCP responses were seen with TTO (mild or severe mucositis) and most parents were not willing to trade any survival time to prevent severe mucositis. Parents were willing to pay significantly more than HCPs to prevent mild mucositis (average median WTP $1,371 CAN vs. $684 CAN, P = 0.031). No differences were seen in WTP to prevent severe mucositis.


Parents and HCP believe severe mucositis to be important, although it is more important to HCPs. Parents would not be willing to reduce life expectancy to eliminate mucositis.


Mucositis Pediatric Time trade-off Visual analogue scale Willingness-to-pay Preferences 



We would like to acknowledge the assistance of Richard Wing, Tania Chung, and Celia Lai in terms of patient recruitment and data management. The project was supported by a Connaught New Staff Matching Grant from the University of Toronto. LS is supported by a New Investigator award from the Canadian Institutes of Health Research. This project was also possible due to the generous support of the employees of Kraft Canada Inc.

Conflict of interest

No conflicts of interest to declare.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Marie-Chantal Ethier
    • 1
  • Dean A. Regier
    • 5
  • Deborah Tomlinson
    • 1
  • Peter Judd
    • 2
    • 4
  • John Doyle
    • 3
  • Adam Gassas
    • 3
  • Ahmed Naqvi
    • 3
  • Lillian Sung
    • 1
    • 3
    • 6
    Email author
  1. 1.Program in Child Health Evaluative SciencesThe Hospital for Sick ChildrenTorontoCanada
  2. 2.Department of DentistryThe Hospital for Sick ChildrenTorontoCanada
  3. 3.Division of Haematology/OncologyThe Hospital for Sick ChildrenTorontoCanada
  4. 4.Department of Dentistry and PaediatricsUniversity of TorontoTorontoCanada
  5. 5.Fred Hutchinson Cancer Research CenterSeattleUSA
  6. 6.27 King’s College CircleTorontoCanada

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