Patient Adherence to Dysphagia Recommendations: A Systematic Review.
Brittany N Krekeler, Courtney K Broadfoot, Stephen Johnson and 2 others
PMID 28965240WHAT IT FOUND
Only twelve original studies directly measured patient adherence to dysphagia recommendations.
Most were in head and neck cancer and relied on self-report. Difficulty and fatigue were common barriers; motivation, support, written instructions, and weekly calls were reported as facilitators.
Key findings
01Only twelve original studies that directly measured patient adherence to dysphagia recommendations were included.
02Most included studies were in head and neck cancer patients, and most recorded adherence by self-report.
03Difficulty of the task and fatigue were the most frequently reported barriers; facilitators included motivation, social support, written instructions, and weekly phone calls.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only twelve studies were included, and nine focused on head and neck cancer, so findings may not apply to other dysphagia causes. Most adherence data were self-reported journals, logs, checklists, or diaries, which can over-report participation. Study designs varied from randomized trials to retrospective studies, case series, and pilot studies, and many had small samples. The included papers often did not describe the therapy or adherence-tracking method specifically enough to know what was measured. The review did not test whether any strategy improves adherence or swallowing outcomes.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not read this review as proof that written instructions, social support, or weekly phone calls improve adherence or swallowing outcomes. It summarizes what twelve mostly self-reported studies observed, and most were in head and neck cancer patients.