The medical term for difficulty swallowing is dysphagia. Although dysphagia can be caused by certain medical conditions, such as oral and oesophageal cancer or stroke, it is more usually a recognised consequence of the aging process attributed to reduced strength of the oral musculature, decreased saliva production and the increasing use of medication known to cause dysphagia.

With an aging population the incidence of patients with swallowing difficulties is increasing. As this section of the population accounts for a significant proportion of dispensing volume, dysphagia is likely to become an increasing problem in terms of both medication administration and treatment.

Swallowing difficulty not only affects the person's ability to take medication, it can lead to an increased risk of weight loss, malnutrition, dehydration, impaired quality of life and an associated risk of aspiration, choking or death. The inability or reluctance to take oral medication can also result in a deterioration of any underlying medical conditions.

Pharmacists are increasingly likely to encounter patients with swallowing difficulties or receive enquiries from other healthcare professionals on suitable treatment options. An understanding of the key issues and concerns will enable pharmacists to provide appropriate, safe and accurate advice.

OBJECTIVES

By the end of this module you will be able to:

• Explain the swallowing reflex.
• Discuss the causes of dysphagia.
• Recognise the signs and symptoms of dysphagia.
• Describe a suitable patient assessment process.
• Provide appropriate advice to patients suffering with dysphagia.
• Provide advice on the manipulation of solid dosage forms.
• Discuss the legal and ethical implications of manipulating solid dosage forms.