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Patient Adherence to Dysphagia Recommendations: A Systematic Review

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A Correction to this article was published on 04 May 2018

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Abstract

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.

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Change history

  • 04 May 2018

    The original version of this article unfortunately contains mistakes. The second sentence in the section “Results”, under the heading “Study Design” was incorrect. It should read as: Two studies [24, 29] used a prospective cohort study design with a JAMA rating of 2. Four studies [17, 25, 27, 34] completed retrospective studies earning a JAMA score of 3. Four studies [26, 28, 30, 33] earned a JAMA quality rating score of 4 and used the following designs: case series [26, 28, 33], and pilot study [30]. In Table 1, “Study Population (n)” and “Design (JAMA quality rating)” values were incorrect for Shinn et al. (2013) [24]. The correct information is given here. HNC (n = 109) Prospective Cohort (2).

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Funding

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

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Authors and Affiliations

  1. Department of Communication Sciences and Disorders, Medical Science Center, University of Wisconsin, 1300 University Avenue, Room 483, Madison, WI, 53706, USA

    Brittany N. Krekeler, Courtney K. Broadfoot, Nadine P. Connor & Nicole Rogus-Pulia

  2. Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, University of Wisconsin, 1975 Willow Drive, 361 Goodnight Hall, Scott H, Madison, WI, 53706-1103, USA

    Brittany N. Krekeler, Courtney K. Broadfoot, Nadine P. Connor & Nicole Rogus-Pulia

  3. Department of Medicine-Geriatrics and Gerontology, University of Wisconsin-Madison, Madison, WI, 53705, USA

    Nicole Rogus-Pulia

  4. Geriatric Research Education and Clinical Center (GRECC) Veterans Administration Hospital, William S. Middleton Memorial Hospital, D5216, 2500 Overlook Terrace, Madison, WI, 53705, USA

    Nicole Rogus-Pulia

  5. Ebling Library, Health Sciences Learning Center, University of Wisconsin, Room 2336, 750 Highland Avenue, Madison, WI, 53705-2221, USA

    Stephen Johnson

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  1. Brittany N. Krekeler
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Correspondence to Brittany N. Krekeler.

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Krekeler, B.N., Broadfoot, C.K., Johnson, S. et al. Patient Adherence to Dysphagia Recommendations: A Systematic Review. Dysphagia 33, 173–184 (2018). https://doi.org/10.1007/s00455-017-9852-9

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