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Observational Study
. 2024 Jan 16;24(1):67.
doi: 10.1186/s12877-023-04589-4.

Adherence to commercial food thickener in patients with oropharyngeal dysphagia

Amaya Peñalva-Arigita  1 , Maria Lecha  2 , Anna Sansano  2 , Rosa Prats  3 , Aida Vásquez  2 , Helena Bascuñana  2   4 , Lluis Vila  5
Affiliations
Observational Study

Adherence to commercial food thickener in patients with oropharyngeal dysphagia

Amaya Peñalva-Arigita et al. BMC Geriatr. .

Abstract

Background: Oropharyngeal dysphagia (OD), a common symptom in the elderly, uses commercial thickener (CT) as part of its treatment. This is often accompanied of dislike and poor compliance.

Aim: Describe adherence to CT and possible differences according to dwelling location in an area of influence of approximately 400.0000 inhabitants.

Methods: Cohort prospective observational study. Randomized patients from Nutrition and Dietetic (NDU)-database (4 calls-interviews/year).

Variables: Age, diagnostic, gender, dwelling/location: Home (H) / Nursing Home (NH), viscosity (nectar, honey, pudding), days with CT. Adherence measured with a questionnaire, considering implementation of treatment by combining CT use and consumption data, categorised in three groups good, moderate and poor. Change in patterns (improvement, maintenance, worsening) and non-adherence reasons.

Results: One hundred sixty-eight patients recruited with indicated viscosity: Nectar 39.7%, honey 29.3% and pudding 30.8%. Average age of 82.6 ± 11.1 years; 57.8% women (46.4% at H vs. 67% at NH, p < 0.01). Dwelling/location: 80 (47.6%) live at H and 88 (52.4%) at NH. Days with CT prior study were 509 ± 475.28. Implementation found in first call: good in 50%, moderate in 20.2% and poor in 29.8%. At first call, adherence parameters were more favourable in NH compared to H. However these parameters were reversed during the study period as there was an improvement at H vs. NH. Also in terms of change in patterns a significant improvement of implementation was found in patients living at H, 31.1% vs. those living at NH, 15.7%, p < 0.05. CT persistence throughout study was 89.7%.

Conclusions: Low adherence to CT found in our community. Telephone follow-up resulted in improved adherence, especially in the H population. Our data provides valuable insights into the variability and changes in CT adherence among patients with OD. Adherence is complex and subject to many factors and dwelling/location is one of them. This study reveals the need to approach CT treatment for OD differently in NH.

Keywords: Adherence; Commercial thickener; Compliance; Dysphagia; Implementation; Persistence.

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Conflict of interest statement

The authors declare no competing interests.

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