Date of Award

2021

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “does honey provide therapeutic relief to patients with chemotherapy induced oral mucositis?”

STUDY DESIGN: Review of one double-blind randomized control trial (RCT), one RCT, and one cohort study.

DATA SOURCES: All articles were published in English and taken from peer-reviewed journals using PubMed. All articles were published between 2012-2019.

OUTCOMES MEASURED: The outcomes measured included decreased severity of oral mucositis measured in one study using the WHO Oral Toxicity Scale and another using WHOSTC (Stomatitis Toxicity Criteria). Another outcome measured was recovery time, which was defined as the number of days from the start of treatment to when complete healing of every ulcer occurred.

RESULTS: The double-blind RCT performed by Raeessi et al. showed a statistically significant difference (p-value<0.001) after treatment with honey when compared to the steroid group. The mean severity of oral mucositis (OM) was 1.43± 0.75 after treatment with the steroid compared to 0.90 ± 0.65 after treatment with honey. The mean difference between the honey and control group was 0.51. Abdulrhman et al. conducted a RCT that showed a statistically significant difference (p-value <0.005) between the mean recovery time (days) of children with OM in the benzocaine group vs. the honey group. For the benzocaine group, the recovery time mean was 6.10±2.47. The honey group recovery time mean was 4.25±1.25. The mean difference between the two groups was 1.85. The cohort study performed by Singh et al. showed a statistically significant reduction (p-value<0.01) in the severity of OM by day 7 between the control group and the experimental honey group. By day 7, 27 (54%) children had Grade 0 OM in the control group, while 46 (92%) children had Grade 0 OM in the honey group. The calculated NNT was 3, the ABI was 0.38, and the RBI was 0.70.

CONCLUSION: All three studies demonstrated that honey provides a statistically significant decrease in severity of OM and recovery time, demonstrating the therapeutic relief honey provides to patients with chemotherapy induced OM.

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