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Published on: March 1, 2015
Exploring Dysphagia Assessment and Management in Canadian Primary Care: A Clinical Practice Survey
Peter Lam1, Erin Bailey2, Cindy Steel2
1University of British Columbia, Vancouver, BC.
Abstract:
Oropharyngeal dysphagia (OD), or dysphagia, is associated with malnutrition, pneumonia, and hospital admissions, and affects up to 35% of older adults in the community. This study aimed to understand dysphagia assessment and management practices among registered dietitians (RDs), speech-language pathologists (SLPs), and occupational therapists (OTs) working with adults in Canadian primary care and to help identify gaps and opportunities to optimize dysphagia patient care.A 22-question online practice survey was administered to RDs, SLPs, and OTs recruited through professional associations and practice groups.A total of 126 respondents partially or fully completed the survey. Clinical swallowing evaluations/mealtime observations were the primary assessment method used by RDs (92%), SLPs (83%), and OTs (50%). Patient education, oral care, and diet modifications were indicated as the top three management strategies. Challenges identified in dysphagia care included patient adherence to management strategies and limited personnel for assessing and managing dysphagia. Inter-professional clinical care pathways, patient/caregiver resources, and professional training for dysphagia assessment were identified to be the most valued resources for providing care.Timely assessment and management are crucial for community-living individuals with dysphagia. Finding unique and sustainable ways to overcome challenges in managing dysphagia in primary care will help improve care for this vulnerable population.
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