Conference Proceedings | J Oral Health Dent. 2017;1(S1):A007 | Open Access
A Randomised Trial of the Effect of Different Fluid Consistencies on Quality of Life
Mulkerrin S1, Lim DJH2, Mulkerrin E2 and O’Keeffe ST2
1Departments of Speech and Language Therapy, Addenbrooke’s Hospital, Cambridge University Hospital Trust, UK
2Geriatric Medicine, Galway University Hospitals; Ireland
Background: Although thickened fluids are commonly advised to minimise the risk of aspiration in people with dysphagia, many do not comply with the recommended treatment. We examined the quality of life utilities associated with use of different consistencies of thickened fluids using a time-trade off (TTO) approach. This involves finding the number of years in full health that subjects would trade off to avoid a particular health state: a utility of 0.6 for a state means that one would be willing to sacrifice 4 years out of a 10 year life span to avoid that state.
Methods: The potential risks of aspiration with thin fluids in dysphagia were explained to consecutive hospital patients without dysphagia (N=76) and health care professionals (N=75) who were then randomised to drink 250 ml of pre-prepared water of either syrup (grade 1) or custard (grade 2) consistency (Nutilis powder). A standardised script was used to elicit TTO utilities associated with long-term use of fluid of that consistency over a 10 year horizon.
Results: Median (interquartile range) utilities were 0.7 (0.5-0.9) for those receiving syrup and 0.5 (0.3-0.7) for those receiving custard consistency fluid (Mann Whitney test p=0.001). There were no significant differences between the utilities of patients and professionals, and age, sex and years of professional experience did not influence results.
Conclusions: Patients and professionals judge that long-term use of thickened fluids would significantly impair quality of life. Utilities associated with more viscous fluids are particularly low.