Background and Importance Dysphagia is a highly prevalent syndrome in the elderly population, and especially in those with cognitive impairment. In addition to age-related factors and comorbidities, drugs with a potential negative effect on swallowing function have been identified, many of which are commonly used in pathologies that are also prevalent in the elderly. Knowing and raising awareness about the dimension of this problem can help increase the safety of pharmacological treatment in these patients.
Aim and Objectives To determine the prevalence of medication prescription with a potential negative effect on swallowing in elderly outpatients with cognitive impairment and diagnosis of dysphagia.
Material and Methods Observational, descriptive and cross-sectional study in which we analysed the pharmacological treatment of patients with cognitive impairment and a diagnosis of dysphagia attending the nutrition hospital pharmacy clinic of a tertiary hospital. We recorded sociodemographic, prescribed medications, potential effect on swallowing function and its mechanism data. Medications with a potential effect on swallowing were selected from the existing literature and the information contained in summaries of products characteristics.
Results We analysed 594 prescriptions corresponding to 68 patients whose mean age was 85,5. We identified 170 drugs belonging to 12 therapeutic groups. 66 patients (97%) had been prescribed some medication with a potential negative effect on swallowing function, and the mean number of these medications prescribed per patient was 3.6. 246 prescriptions (41,6%) corresponded to medications with negative potential on the swallowing function, mainly due to their sedative effect (n=118, 48%), followed by production of xerostomia (n=44, 18%), neuromuscular action (n=33, 13.4%), direct irritants (n=18, 7.3%), and unknown mechanisms (n= 4%). 23 prescriptions (9,3%) shared different mechanisms.
Conclusion and Relevance We observed a high prevalence of drug prescriptions with a potential negative effect on swallowing in this subgroup of patients. These results highlight the importance of re-evaluating the clinical need for these medical prescriptions in patients with dysphagia. Hospital pharmacy has an important role in detecting these medical prescriptions and promoting the search for alternatives to ensure the best benefit-risk ratio. The need to extend the study to other subpopulations of patients with dysphagia should be considered.
Conflict of Interest No conflict of interest.
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