Exploring speech pathology service delivery and dysphagia identification in a community pulmonary rehabilitation program for people with chronic obstructive pulmonary disease.

Abstract

Background: People diagnosed with chronic obstructive pulmonary disease (COPD) can develop dysphagia. Community programs such as the multi-disciplinary pulmonary rehabilitation program for people with COPD often include dysphagia education, however education alone is insufficient to identify and manage dysphagia. We present Phase 1 results from a larger study investigating the implementation of routine dysphagia screening in a pulmonary rehabilitation program for people with COPD. Aim(s): Explore current practices related to dysphagia identification for people with COPD enrolled in a pulmonary rehabilitation program in a regional health service. Method: Audit of medical records from 2014-2018 of people enrolled in a community pulmonary rehabilitation program to determine referral patterns (referrals for clinical and instrumental swallowing assessments) and time difference between referral to speech pathology and the identification of dysphagia. Result(s): Preliminary review of referral data at Ballarat Health Services over the five-year period shows 16% of people who participated in the pulmonary rehabilitation program were referred to speech pathology for swallowing concerns. Few of these referrals were seen during the person’s outpatient episode of care; and the majority of the referrals were triggered once the person was admitted to hospital. We will also explore the frequency of instrumental assessments within this population during this period. Conclusion: There is no systematic approach to dysphagia identification within the pulmonary rehabilitation program for people with COPD at this health service. Data from this study will provide baseline information to compare dysphagia identification practices after implementation of routine dysphagia screening into the program (Phase 2).