J Korean Dysphagia Soc.  2014 Jul;4(2):60-67.

Compliance with Viscosity-modified Diet among Patients with Dysphagia

  • 1Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 2Kangwon-do Rehabilitation Hospital, Chuncheon, Korea


To compare the characteristics of dysphagic patients who are and are not compliant with viscosity-modified diet and investigate the reasons for non-compliance. Method: A total of 130 dyaphagic patients who had been recommended to use fluid thickeners for diet after videofluoroscopic swallowing study (VFSS) were enrolled. Compliance of viscosity-modified diet and the reasons for not using fluid thickener were determined by a questionnaire. In addition, patient characteristics, such as sex, age, underlying disease, previous recommended diet, number of VFSS done, place where patient live, current method of fluid thickening, duration of thickener use, people who prepare the viscosity-modified diet, experience of aspirating symptom or aspiration pneumonia, information about thickener and dysphagia education were assessed by the questionnaire. The relationship between each factor and compliance was analyzed by chi-square and regression test. Result: Among 130 patients who were enrolled, 95 (73.1%) were compliers, and 35 (26.9%) were non-compliers. The most common reason for non-compliance was patient’s perceived improvement of swallowing function (18 persons, 29.0%), and dislike of the taste (10 persons, 16.1%) and strange texture (8 persons, 12.9%). The cost of thickener (7 persons, 11.3%), inconvenience of the usage (7 persons, 11.3%) and purchase (2 persons, 3.2%), adverse effect on swallowing by using of thickener (5 persons, 8.1%) were also reported. Higher age (P<0.01) and educational session for the usage of thickener (P<0.05) were associated with the compliance.
To improve compliance with viscosity-modified diet, it is important to provide an adequate education about the usage of fluid thickener especially to young patient with dysphagia. And development of convenient and reasonably-priced fluid thickeners with more acceptable taste and texture is required.


Compliance; Deglutition disorders; Diet therapy
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