Dysphagia Identification and Assessment in Adults in Primary Care Settings-A Canadian Study of Dietitians.

Dysphagia affects up to 35% of older adults living in the community and is considered a significant risk factor for malnutrition and aspiration. Early intervention is important, yet dietitian referrals for dysphagia management in primary care are disproportionately low considering the prevalence of dysphagia and its risk factors. As little is known about dietitian's current dysphagia identification and assessment practices in Canada, an online survey was developed. Registered dietitians practicing in primary care were invited to participate. Of the 70 surveys completed, nearly 75% do not have a dysphagia screening process where they practice, and only 8% reported performing noninstrumental, clinical swallowing assessment (CSA). Lack of competency or skills required to complete dysphagia screening and assessment was the most reported barrier. Many respondents were unsure or did not believe CSA fell within their scope of practice, and over 70% reported needing hands-on dysphagia screening and assessment training. Current practices in primary care could be placing individuals with dysphagia, and those at risk, in jeopardy of being overlooked. Initiatives to increase dysphagia awareness, create screening processes, and increase awareness of dietitian's scope of practice are needed to enable primary care dietitians to develop competency in dysphagia screening and assessment.