Exploring Dysphagia Assessment and Management in Canadian Primary Care: A Clinical Practice Survey
Publication: Canadian Journal of Dietetic Practice and Research
17 March 2025
Abstract
Oropharyngeal dysphagia (OD), or dysphagia, is associated with malnutrition, pneumonia, and hospital admissions, and affects up to 35% of older adults in the community. This study aimed to understand dysphagia assessment and management practices among registered dietitians (RDs), speech-language pathologists (SLPs), and occupational therapists (OTs) working with adults in Canadian primary care and to help identify gaps and opportunities to optimize dysphagia patient care.
A 22-question online practice survey was administered to RDs, SLPs, and OTs recruited through professional associations and practice groups.
A total of 126 respondents partially or fully completed the survey. Clinical swallowing evaluations/mealtime observations were the primary assessment method used by RDs (92%), SLPs (83%), and OTs (50%). Patient education, oral care, and diet modifications were indicated as the top three management strategies. Challenges identified in dysphagia care included patient adherence to management strategies and limited personnel for assessing and managing dysphagia. Inter-professional clinical care pathways, patient/caregiver resources, and professional training for dysphagia assessment were identified to be the most valued resources for providing care.
Timely assessment and management are crucial for community-living individuals with dysphagia. Finding unique and sustainable ways to overcome challenges in managing dysphagia in primary care will help improve care for this vulnerable population.
Résumé
La dysphagie oropharyngée, ou dysphagie, est associée à la malnutrition, à la pneumonie et à des hospitalisations. Elle touche jusqu’à 35 % des adultes plus âgés dans la communauté. Cette étude visait à comprendre les pratiques d’évaluation et de gestion de la dysphagie chez les diététistes, orthophonistes (OP) et ergothérapeutes (ET) travaillant avec des adultes en soins primaires au Canada, et à identifier les lacunes et les possibilités d’optimiser les soins aux patients dysphagiques.
Un sondage en ligne de 22 questions sur la pratique a été mené auprès de diététistes, d’OP et d’ET recrutés dans des associations professionnelles et groupes de pratique.
Au total, 126 personnes ont répondu partiellement ou entièrement au sondage. Les évaluations cliniques de la déglutition et les observations au cours des repas étaient la principale méthode d’évaluation utilisée par les diététistes (92 %), les OP (83 %) et les ET (50 %). L’éducation du patient, les soins buccodentaires et les changements à l’alimentation étaient les trois principales stratégies de prise en charge. Les défis ciblés dans les soins de la dysphagie étaient l’adhésion du patient aux stratégies de gestion et le manque de personnel pour évaluer et gérer la dysphagie. Les soins cliniques interprofessionnels, les ressources pour les patients/aidants et la formation professionnelle sur l’évaluation de la dysphagie ont été identifiés comme étant les ressources les plus utiles pour offrir des soins.
Une évaluation et une prise en charge rapides sont cruciales pour les personnes atteintes de dysphagie vivant en communauté. Trouver des moyens uniques et durables de surmonter les difficultés liées à la gestion de la dysphagie en soins primaires contribuera à améliorer les soins pour cette population vulnérable.
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Financial support: Funding for the development, distribution, and analysis of this practice-based survey was provided by Nestlé Health Science Canada.
Conflicts of interest: PL received funding to support this work. EB and CS are employees of Nestlé Health Science Canada.
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Canadian Journal of Dietetic Practice and Research
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Pages: 1 - 6
Editor: Naomi Cahill
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Version of record online: 17 March 2025
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© 2025.
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PeterLamRD, ErinBaileyMSc, RD, and CindySteelMSc, RD. Exploring Dysphagia Assessment and Management in Canadian Primary Care: A Clinical Practice Survey. Canadian Journal of Dietetic Practice and Research.
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https://doi.org/10.3148/cjdpr-2025-001
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