Dysphagia and medication management: A pharmacy and speech pathology collaboration.

Samantha Kirk1, Jane Gabb2, Nicole Stevens3

14th Year Speech Pathology Student, The University of Newcastle, Callaghan NSW 2308, Samantha.Kirk@uon.edu.au
2Pharmacist, Wyong Hospital Pharmacy Department, Hamlyn Terrace NSW 2259
3Clinical Educator, Speech Pathology Department, Wyong Hospital; Hamlyn Terrace NSW 2259

Background

Delivery of oral medications in patients prescribed thickened fluids for management of dysphagia is a challenge within the hospital setting. A gap in knowledge was identified in the pharmacy department of a major metropolitan hospital, with regards to how to safely manage oral medication administration with this cohort.

Methods

For phase 1-education was provided to the pharmacy department on the incidence and aetiology of dysphagia, why thickened fluids were recommended by speech pathology, and which oral medications were suitable for patients prescribed thickened fluids.

For Phase-2 a safe method to appropriately mix the solutions of potassium and phosphate with thickened water, and retain a level of thickness suitable for administration was developed.

Time trials and line spread tests were used to compare; viscosity of level 1, 2 and 3 hospital thickened fluids and the thickened fluids mixed with solutions of potassium and phosphate.

Results

Phase-1: post-presentation results included:

  • 60% of pharmacists reported no recent contact with speech pathology.
  • 60% requested advice managing patients on thickened fluids and prescribed oral effervescent potassium and phosphate.
  • 100% reported a ‘flip-tag’ outlining suitable medication forms for thickened fluids would be a valuable reference tool.
  • 100% reported increased understanding of speech pathology’s role.

Phase-2: Results will be graphed. Statistical analysis will report significant correlations and differences.

Discussion

The major limitation of Phase-2 is the unknown impact of thickened fluid on the bioavailability of the medication.

Phase-2 trial results will be collated and charted onto a flip-tag reference tool for use within this hospital.