Patient Adherence to Dysphagia Recommendations: A Systematic Review

Krekeler, Brittany N.; Broadfoot, Courtney K.; Johnson, Stephen C.; Connor, Nadine P.; Rogus-Pulia, Nicole

doi:10.1007/s00455-017-9852-9

Cited by 66 publications

(62 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results are consistent with previous reports stating that half of patients’ status post–larynx‐preserving RT demonstrate chronic aspiration yet remain gastrostomy‐free . Practically, the patient who does not have an awareness of aspiration or accumulation of pharyngeal residue may be less likely to adhere to therapeutic interventions for safe swallowing that recommend changes in diet consistency or swallowing maneuvers …”

Section: Discussionsupporting

confidence: 91%

Patient‐reported versus physiologic swallowing outcomes in patients with head and neck cancer after chemoradiation

et al. 2018

View full text Add to dashboard Cite

Objective The primary objective of this project was to retrospectively investigate the relationship between patient‐reported and physiologic swallowing measures after chemoradiation therapy for head neck cancer (HNC). Methods Adult patients who underwent chemoradiation therapy for HNC and presented for videofluoroscopic swallow study were reviewed retrospectively. Surgically treated patients were excluded. Patient perception of swallowing‐related outcomes was assessed via the MD Anderson Dysphagia Inventory (MDADI) on the same day that physiologic measures of swallow function were obtained. Using vidoefluoroscopic data, the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale yielded measures of safety (DIGEST‐S: penetration/aspiration) and efficiency (DIGEST‐E: residue). Statistical analysis for correlation coefficients was performed. Results Thirty patients met the inclusion criteria. The oropharynx was the most commonly affected site (70.0%), followed by the larynx (16.7%). The median radiation dose was 72 grays (Gy), and participants were assessed a mean of 4.6 (range 0–12) years following completion of treatment. There was no correlation between the MDADI and the DIGEST‐E score (Pearson rho = −0.045, P = 0.812), DIGEST‐S score (Pearson rho = 0.075, P = 0.695), or summary DIGEST grade (Pearson rho = 0.046, P = 0.810). MDADI scores did not change significantly with increasing time since radiation (P = 0.375), whereas the DIGEST‐E scores, DIGEST‐S score, and summary DIGEST grades worsened over time (P = 0.007, P = 0.002, and P = 0.0005, respectively). Conclusion Assessment of swallowing physiology showed that function worsened after chemoradiation therapy, but this did not correlate with patient‐reported quality‐of‐life measures. Reduced patient awareness of swallow dysfunction years after completion of chemoradiation has implications for management of dysphagia in the face of physiologic decline. Level of Evidence 4 Laryngoscope, 129:2059–2064, 2019

show abstract

Section: Discussionsupporting

confidence: 91%

Patient‐reported versus physiologic swallowing outcomes in patients with head and neck cancer after chemoradiation

et al. 2018

View full text Add to dashboard Cite

show abstract

“…While it has been suggested thicker liquids (eg, honey‐thick consistency) may improve some measures of swallowing, such as decreases in the occurrence of airway invasion on videofluoroscopy, increases in dehydration with decreases in quality of life have also been reported . Additionally, studies have shown adherence to recommendations for thickened liquids to be low overall . Studies evaluating the impact of modification of food and fluid consistency on the incidence of aspiration for patients with head and neck cancer and with Parkinson disease are low quality and inconclusive.…”

Section: Management Of Dysphagia In Older Adultsmentioning

confidence: 99%

Swallowing Disorders in the Older Population

Christmas

Rogus-Pulia

2019

J American Geriatrics Society

102

View full text Add to dashboard Cite

Swallowing problems, or dysphagia, are common as people age, and are associated with significant negative outcomes, including weight loss, pneumonia, dehydration, shortened life expectancy, reduced quality of life, and increased caregiver burden. In this article, we will discuss the complex process of swallowing in normal circumstances and with healthy aging, then review etiologies that contribute to dysphagia. We will discuss approaches to evaluating and treating dysphagia, providing relevant data where they are available. We highlight the desperate need for high‐quality research to guide best practices in treating dysphagia in older adults. J Am Geriatr Soc 67:2643–2649, 2019

show abstract

“…Whereas most patients with HNC have been reported to undergo recommended tumor treatments, still a significant number either choose alternatives (eg, 7%) or choose not to undergo parts of the recommended treatment (eg, 3%, 4%, and 2%). Also, adherence rates for self‐care regimens during treatment vary widely between 17% and 80% depending on assessment, time in treatment, or inpatient versus outpatient status . Studies investigating predictors of treatment adherence among patients with HNC often focus on stable factors.…”

Section: Introductionmentioning

confidence: 99%

“…For instance, in a retrospective study investigating potential predictors of adherence to treatment guidelines in patients and physicians, Dronkers et al focused on nonmodifiable variables and found that demographic (older age, single marital status, and female gender) as well as biomedical factors (high tumor stage and severe comorbidity) were associated with refusal of standard treatment. Regarding adherence to self‐care regimens during medical treatment, relatively more evidence on modifiable factors has been reported . In a systematic review, Krekeler and colleagues listed difficulty of the tasks and fatigue as most frequently reported barriers to adherence to self‐care regimens.…”

Section: Introductionmentioning

confidence: 99%

“…Regarding adherence to self‐care regimens during medical treatment, relatively more evidence on modifiable factors has been reported . In a systematic review, Krekeler and colleagues listed difficulty of the tasks and fatigue as most frequently reported barriers to adherence to self‐care regimens. The authors found only 2 studies with HNC patients tackling modifiable facilitators including motivational, well‐being, social, and environmental factors …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation