Abstract
Introduction: A variety of medicines may impair the swallowing function with observed adverse effects. On the other hand, required medicines may not be taken due to dysphagia, and the known efficacy of medicines may not be as expected. The purpose of this study is to analyze medicines proposed by the pharmacist and to consider the role of pharmacist as part of the swallowing support team (SST).
Methods: The subjects were dysphagia patients who were examined in the case conference of SST from March 20XX to April 20XX ＋ 3. The administration of medicine, the proposals related to medicine, achievement of pharmaceutical intervention, and the severity of dysphagia before and after the intervention were studied retrospectively.
Results: 51 dysphagia patients (median, 82 yo) were examined by SST and 42 out of 51 (82%) took medicines which might impair the swallowing function. The most common medicine which might impair the swallowing function was the sleeping drug and the antipsychotics. The most commonly administered medicine which might improve the swallowing function was angiotensin converting enzyme inhibitors. Pharmaceutical proposals were made to 29 patients and 25 were intervened. SST suggested the cancellation or reduction of medicines which might impair the swallowing function to 10 patients; changing the administration of medicines to 9 patients and, adding medicines with good effect for swallowing function and/or changing medicines to 7 patients. The average score of food intake level scale (FILS) in 25 pharmaceutical intervened patients was 4.5 before intervention and 5.9 at discharge. Average score improved 1.4. The score in 26 non-pharmaceutical intervened patients was 5.1 before intervention and 6.3 at discharge. Improvement was 1.2 indicating a statistical insignificant change compared to the pharmaceutical intervention group.
Conclusion: Many patients are administered medicines which may unknowingly impair the swallowing function. Therefore, pharmaceutical proposals must be carefully considered and administered for dysphagia patients. It is wished the pharmacist plays a role as part of SST pointing out medicines which may impair the swallowing function, proposing alternative medicines and, safely and firmly supporting the administration of medicines to dysphagia patients.
