经口进食困难患者对商业食品增稠剂的依从性。
Adherence to commercial food thickener in patients with oropharyngeal dysphagia.
机构信息
Nutritional & Dietetics Unit, Hospital Moisès Broggi, Oriol, C. d'Oriol Martorell, 12, Sant Joan Despí, Barcelona, 08970, Spain.
Nutritional & Dietetics Unit, Hospital Moisès Broggi, C. d'Oriol Martorell 12., Sant Joan Despí, Barcelona, 08970, Spain.
出版信息
BMC Geriatr. 2024 Jan 16;24(1):67. doi: 10.1186/s12877-023-04589-4.
BACKGROUND
Oropharyngeal dysphagia (OD), a common symptom in the elderly, uses commercial thickener (CT) as part of its treatment. This is often accompanied of dislike and poor compliance.
AIM
Describe adherence to CT and possible differences according to dwelling location in an area of influence of approximately 400.0000 inhabitants.
METHODS
Cohort prospective observational study. Randomized patients from Nutrition and Dietetic (NDU)-database (4 calls-interviews/year).
VARIABLES
Age, diagnostic, gender, dwelling/location: Home (H) / Nursing Home (NH), viscosity (nectar, honey, pudding), days with CT. Adherence measured with a questionnaire, considering implementation of treatment by combining CT use and consumption data, categorised in three groups good, moderate and poor. Change in patterns (improvement, maintenance, worsening) and non-adherence reasons.
RESULTS
One hundred sixty-eight patients recruited with indicated viscosity: Nectar 39.7%, honey 29.3% and pudding 30.8%. Average age of 82.6 ± 11.1 years; 57.8% women (46.4% at H vs. 67% at NH, p < 0.01). Dwelling/location: 80 (47.6%) live at H and 88 (52.4%) at NH. Days with CT prior study were 509 ± 475.28. Implementation found in first call: good in 50%, moderate in 20.2% and poor in 29.8%. At first call, adherence parameters were more favourable in NH compared to H. However these parameters were reversed during the study period as there was an improvement at H vs. NH. Also in terms of change in patterns a significant improvement of implementation was found in patients living at H, 31.1% vs. those living at NH, 15.7%, p < 0.05. CT persistence throughout study was 89.7%.
CONCLUSIONS
Low adherence to CT found in our community. Telephone follow-up resulted in improved adherence, especially in the H population. Our data provides valuable insights into the variability and changes in CT adherence among patients with OD. Adherence is complex and subject to many factors and dwelling/location is one of them. This study reveals the need to approach CT treatment for OD differently in NH.
背景
口咽吞咽困难（OD）是老年人的常见症状，其治疗方法之一是使用商业增稠剂（CT）。但患者常对此表示反感且依从性差。
目的
描述在大约 400000 名居民的影响区域内，根据居住地点的不同，对 CT 的依从情况及可能存在的差异。
方法
前瞻性队列观察研究。从营养与饮食数据库（NDU）中随机抽取患者（每年 4 次电话访谈）。
变量
年龄、诊断、性别、居住/地点：家庭（H）/养老院（NH）、黏度（花蜜、蜂蜜、布丁）、使用 CT 的天数。通过问卷来衡量依从性，将 CT 的使用和消费数据相结合来考虑治疗的实施情况，将依从性分为三组：良好、中等和不良。并记录依从性模式的变化（改善、维持、恶化）和不依从的原因。
结果
共招募了 168 名符合要求黏度的患者：花蜜 39.7%、蜂蜜 29.3%、布丁 30.8%。平均年龄 82.6±11.1 岁；57.8%为女性（H 为 46.4%，NH 为 67%，p<0.01）。居住/地点：80 人（47.6%）居住在 H，88 人（52.4%）居住在 NH。研究前使用 CT 的天数为 509±475.28。首次电话访谈时的实施情况为：良好占 50%，中等占 20.2%，不良占 29.8%。首次电话访谈时，NH 组的依从性参数优于 H 组。然而，在研究期间，这些参数发生了逆转，因为 H 组的依从性有所改善，而 NH 组则没有。此外，在模式变化方面，与 NH 组的 15.7%相比，H 组的患者有 31.1%实现了实施情况的显著改善，p<0.05。整个研究期间 CT 持续使用率为 89.7%。
结论
我们的社区中 CT 的依从性较低。电话随访可提高依从性，尤其是在 H 人群中。我们的数据为口咽吞咽困难患者 CT 依从性的变异性和变化提供了有价值的见解。依从性是复杂的，受到许多因素的影响，居住/地点是其中之一。这项研究揭示了在 NH 中需要以不同的方式处理 OD 的 CT 治疗。
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