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Overview of Results From the Largest Clinical Trial for Dysphagia Treatment Efficacy

Department of Medicine, Department of Radiology, Interdepartmental Nutritional Sciences Graduate Program and Biomedical Engineering at University of Wisconsin; and Geriatric Research, Education and Clinical Center at the William S. Middleton Memorial Veterans Hospital
Madison, WI

Jacqueline Hind

Department of Medicine, University of Wisconsin Hospitals and Clinics; and Geriatric Research, Education and Clinical Center at the William S. Middleton Memorial Veterans Hospital
Madison, WI

Information presented herein provides an overview of the largest randomized clinical trial ever completed in dysphagia. The two-part sequential randomized clinical trial studied the effect of two common dysphagia interventions (chin tuck and thickened liquids) for immediate prevention of aspiration during videofluorographic assessment and also for the incidence of pneumonia at 3-months for patients with Parkinson's disease and/or dementia. Results indicated that thickened liquids (nectar-thick or honey-thick) prevented aspiration during the radiographic study more frequently than chin-down posture; however, both interventions were equally successful at preventing pneumonia. Adverse events such as urinary tract infection and dehydration were more common with thickened liquids. Median length of hospital stay due to pneumonia was three times longer for patients drinking honey-thick liquids compared to nectar-thick and chin-tuck arms of the study. Several important secondary outcomes are discussed as well as implications for clinical practice. The reader is encouraged to refer to other published works for detailed information that is highlighted in this overview.