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. 2017 Sep 28:11:1687-1699.
doi: 10.2147/PPA.S142653. eCollection 2017.

Swallowing difficulties with medication intake assessed with a novel self-report questionnaire in patients with systemic sclerosis - a cross-sectional population study

Markus Messerli  1   2 , Rebecca Aschwanden  1 , Michael Buslau  2 , Kurt E Hersberger  1 , Isabelle Arnet  1
Affiliations

Swallowing difficulties with medication intake assessed with a novel self-report questionnaire in patients with systemic sclerosis - a cross-sectional population study

Markus Messerli et al. Patient Prefer Adherence. .

Abstract

Objectives: To assess subjective swallowing difficulties (SD) with medication intake and their practical consequences in patients suffering from systemic sclerosis (SSc) with a novel self-report questionnaire.

Design and setting: Based on a systematic literature review, we developed a self-report questionnaire and got it approved by an expert panel. Subsequently, we sent the questionnaire by post mail to SSc patients of the European Center for the Rehabilitation of Scleroderma Rheinfelden, Switzerland.

Participants: Patients were eligible if they were diagnosed with SSc, treated at the center, and were of age ≥18 years at the study start.

Main outcome measures: Prevalence and pattern of SD with oral medication intake, including localization and intensity of complaints.

Results: The questionnaire consisted of 30 items divided into five sections Complaints, Intensity, Localization, Coping strategies, and Adherence. Of the 64 SSc patients eligible in 2014, 43 (67%) returned the questionnaire. Twenty patients reported SD with medication intake (prevalence 47%), either currently (11; 26%) or in the past that had been overcome (9; 21%). Self-reported SD were localized mostly in the larynx (43%) and esophagus (34%). They were of moderate (45%) or strong to unbearable intensity (25%). Modification of the dosage form was reported in 40% of cases with SD. Adherence was poor for 20 (47%) patients and was not associated with SD (p=0.148).

Conclusion: Our novel self-report questionnaire is able to assess the pattern of complaints linked to medication intake, that is, localization and intensity. It may serve as a guide for health care professionals in selecting the most suitable therapy option, enabling tailored counseling to reduce inappropriate medication modifications.

Keywords: coping behavior; deglutition disorders; medication intake; self-report questionnaire; swallowing difficulties; systemic sclerosis.

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Conflict of interest statement

Disclosure All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf. The authors report no conflicts of interest in this work and declare no support from any organization for the submitted work, no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years, and no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1
Flow chart of the systematic literature search.
Figure 2
Figure 2
Localization of patient’s swallowing difficulties with medication intake (35 marks provided by 19 patients). Note: The segments correspond to the stages of the physiologic swallowing process, that is, oral preparatory stage (mouth), oral propulsive stage (throat), pharyngeal stage (pharynx), and esophageal stage (esophagus).
Figure 3
Figure 3
Answers of the 20 patients who reported SD concerning general complaints associated with deglutition disorders. Note: The darker the bar, the higher is the burden. Abbreviation: SD, swallowing difficulties.
See this image and copyright information in PMC

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