, Volume 33, Issue 2, pp 173–184 | Cite as

Patient Adherence to Dysphagia Recommendations: A Systematic Review

  • Brittany N. Krekeler
  • Courtney K. Broadfoot
  • Stephen Johnson
  • Nadine P. Connor
  • Nicole Rogus-Pulia
Review Article


Patient adherence to treatment recommendations is an important issue for healthcare providers, in a multitude of specialties, and is critical when assessing the efficacy and effectiveness of a particular treatment approach. Patients who have swallowing impairment often require complex and specific interventions requiring altered daily patterns of behavior. Patients with dysphagia who do not follow recommendations or prescribed exercises may not receive maximum benefit of an intervention. Poor adherence also makes it more difficult to evaluate efficacy of a treatment both clinically and in experimental settings. Further, swallow safety can be compromised if certain recommendations are not followed. Our purpose was to systematically review the literature to understand what is known about adherence within the field of dysphagia treatment. We systematically identified 12 studies that tracked and reported patient-specific adherence. In this review, we found that the average adherence rate from these studies ranges between 21.9 and 51.9%. Adherence to prophylactic treatment recommendations for patients with head and neck cancer was the focus in 9/12 studies. The findings of this review identify a large gap in knowledge regarding adherence to dysphagia treatment. Few studies account for adherence within their study designs. When planning dysphagia treatment studies, it is imperative that investigators include information regarding patient adherence to accurately interpret findings. Given the variable adherence rates found in this review, factors influencing patient adherence with dysphagia treatments should be identified to increase adherence in future trials.


Swallowing Deglutition Deglutition disorders Dysphagia Adherence Systematic review Dysphagia treatment 



This study was funded in part by the National Institute on Deafness and Other Communication Disorders (R01DC005935, R01DC008149, R01DC014358, T32-DC009401).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

455_2017_9852_MOESM1_ESM.docx (142 kb)
Supplementary material 1 (DOCX 142 kb)


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Brittany N. Krekeler
    • 1
    • 2
  • Courtney K. Broadfoot
    • 1
    • 2
  • Stephen Johnson
    • 5
  • Nadine P. Connor
    • 1
    • 2
  • Nicole Rogus-Pulia
    • 1
    • 2
    • 3
    • 4
  1. 1.Department of Communication Sciences and Disorders, Medical Science CenterUniversity of WisconsinMadisonUSA
  2. 2.Division of Otolaryngology—Head and Neck Surgery, Department of SurgeryUniversity of WisconsinMadisonUSA
  3. 3.Department of Medicine-Geriatrics and GerontologyUniversity of Wisconsin-MadisonMadisonUSA
  4. 4.Geriatric Research Education and Clinical Center (GRECC) Veterans Administration HospitalWilliam S. Middleton Memorial HospitalMadisonUSA
  5. 5.Ebling Library, Health Sciences Learning CenterUniversity of WisconsinMadisonUSA

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