Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training

Authors

  • James Coyle Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh

DOI:

https://doi.org/10.5195/ijt.2012.6093

Abstract

Many patients survive severe stroke because of aggressive management in intensive care units.  However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP), a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians.  Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas.  Tele-dysphagia management has the potential to increase patients’ survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year.  Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.

  

Author Biography

James Coyle, Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh

James Coyle is an Assistant Professor of Communication Science and Disorders Department at the University of Pittsburgh, with a principal clinical and research interest in oropharyngeal dysphagia, its assessment and management, biomechanical analysis of swallowing physiology, and medical sequelae caused by dysphagia. He is a Board Recognized Specialist in Swallowing Disorders, and a member of the Specialty Recognition Board. He served in the Communication Sciences and Disorders Clinical Trials Research Group (CSDRG) as a Regional Principal Investigator for Protocol 201, a multi-site randomized clinical trial investigating the effects of dysphagia treatments on pneumonia outcomes among aspirating adults. He has authored or co-authored peer reviewed scientific and review articles and chapters in the field of motor speech and swallowing disorders, and served as a reviewer for Dysphagia and other peer reviewed journals.

References

Baine, W.B., Yu, W., & Summe, J.P. (2001). Epidemiologic trends in the hospitalization of elderly Medicare patients for pneumonia, 1991-1998. American Journal of Public Health,91,1121-1123.

Centers for Disease Control and Prevention, (2009), Retrieved from: http://www.cdc.gov/nchs/data/dvs/deaths_2009_release.pdf.

Hilker, R., Poetter, C., Findeisen, N., Sobesky, J., Jacobs, A., Neveling, M., & Heiss, W.D. (2003). Nosocomial pneumonia after acute stroke: Implications for neurological intensive care medicine. Stroke, 34,975-81.

Katzan, I.L., Cebul, R.D., Husak, S.H., Dawson, N.V., & Baker, D.W. (2003). The effect of pneumonia on mortality among patients hospitalized for acute stroke. Neurology, 60,620-625.

Malandraki, G.A., McCullough, G., He, X., McWeeny, E., & Perlman, A.L. (2011). Teledynamic evaluation of oropharyngeal swallowing. Journal of Speech, Language, and Hearing Research, 54,1497-505

Niederman, M.S., McCombs, J.S., Unger, A.N., Kumar, A., & Popovian, R. (1998). The cost of treating community-acquired pneumonia. Clinical Therapeutics, 20,820-837.

Perlman, A. L., & Witthawaskul, W. (2002). Real-time remote telefluoroscopic assessment of patients with dysphagia. Dysphagia, 17, 162-167.

Published

2012-06-06

How to Cite

Coyle, J. (2012). Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training. International Journal of Telerehabilitation, 4(1), 41–46. https://doi.org/10.5195/ijt.2012.6093

Issue

Section

Brief Communications