Ann Rehabil Med.  2013 Oct;37(5):628-632. 10.5535/arm.2013.37.5.628.

Factors Associated With Compliance With Viscosity-Modified Diet Among Dysphagic Patients

• Shim JS
• Oh BM
• Han TR

• KMID: 2266579
• DOI: http://doi.org/10.5535/arm.2013.37.5.628

Abstract

OBJECTIVE
To investigate compliance with a viscosity-modified diet among Korean dysphagic patients and to determine which factors are associated with compliance.
METHODS
We retrospectively reviewed medical records of patients who had been recommended to use thickeners in the previous videofluoroscopic swallowing study (VFSS). Among 68 patients, 6 were excluded because tube feeding was required due to deterioration in their medical condition. Finally, 62 patients were included in the study. Patient compliance was assessed using their medical records by checking whether he or she had maintained thickener use until the next VFSS. To determine which factors affect compliance, the relationship between thickener use and patient characteristics, such as sex, age, inpatient/outpatient status, severity of dysphagia, aspiration symptoms, follow-up interval of VFSS, and current swallowing therapy status were assessed. For noncompliers, reasons for not using thickeners were investigated by telephone interview.
RESULTS
Among 62 patients, 35 (56.5%) were compliers, and 27 (43.5%) were noncompliers. Eighteen (90%) of 20 inpatients had followed previous recommendations; however, only 17 (40.5%) of 42 outpatients had been using thickeners. Of patient characteristics, only admission status was significantly correlated with compliance. When asked about the reason why they had not used thickeners, noncompliers complained about dissatisfaction with texture and taste, greater difficulty in swallowing, and inconvenience of preparing meals.
CONCLUSION
Among Korean dysphagic patients, compliance with a viscosity-modified liquid diet was only about 50%. Betterments of texture and taste along with patient education might be necessary to improve compliance with thickener use.

Keyword

Compliance; Deglutition disorders; Diet therapy

MeSH Terms

Compliance*
Deglutition
Deglutition Disorders
Diet*
Enteral Nutrition
Follow-Up Studies
Humans
Inpatients
Medical Records
Outpatients
Patient Compliance
Patient Education as Topic
Retrospective Studies
Telephone

Figure

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  Fig. 1 Flow chart of the study design.

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  Fig. 2 Compliance difference between outpatients and inpatients. Outpatients showed lower compliance than inpatients (n=62).

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  Fig. 3 Examples of modified diet. (A) Liquids with honey-like viscosity and mechanically altered solids. (B) Liquids with nectar-like viscosity and pureed solids.

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