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Dysphagia: addressing medication difficulties in primary care

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Prescribers may want to consider alternative routes of drug administration for patients with dysphagia

Dysphagia literally means difficulty eating or swallowing.1 Dysphagia can adversely affect a person’s health and wellbeing because affected individuals may be unable to take prescribed medication and have difficulties eating and drinking. This article, the first of two, explores how nurses can identify and address difficulties with medication. The second article will explore how nurses can address problems relating to nutrition and hydration.

The prevalence of dysphagia rises with age and is associated with neurological conditions and certain long term conditions. Around 11% of adults living in their own homes have dysphagia.2 Frail older people, those with neurological problems such as stroke and Parkinson’s disease and those with, chronic obstructive airways disease (COPD) are at greater risk of developing swallowing problems (see figure one).3,4,5,6,7

Why does dysphagia occur?

The normal swallow has 4 phases (see table one) and is dependent on an intact motor and nervous system.8 Conditions that affect the motor or nervous system such as dementia, stroke, multiple sclerosis and Parkinson’s disease increase the risks of dysphagia. Age related changes including changes to dentition, saliva production and motor function also increase the risks of dysphagia.9

If dysphagia is suspected


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