What assessment tools are recommended for evaluating swallowing disorders in adults in primary care?

Within primary care settings, UK guidelines do not specify particular assessment tools for evaluating swallowing disorders in adults. Instead, the primary recommendation is for healthcare professionals to recognise indicators of dysphagia and refer individuals to specialists ¹.

Indicators of dysphagia that should prompt referral include:

• Obvious indicators: difficult or painful chewing or swallowing, regurgitation of undigested food, difficulty controlling food or liquid in the mouth, drooling, hoarse voice, coughing or choking before, during, or after swallowing, globus sensation, nasal regurgitation, feeling of obstruction, and unintentional weight loss ¹.
• Less obvious indicators: change in respiration pattern, unexplained temperature spikes, wet voice quality, tongue fasciculation, xerostomia, heartburn, change in eating habits (e.g., eating slowly or avoiding social occasions), frequent throat clearing, recurrent chest infections, and atypical chest pain ¹.

People presenting with any of these indicators should be referred to healthcare professionals with relevant skills and training in the diagnosis, assessment, and management of swallowing disorders ¹. Healthcare professionals should also recognise that individuals with acute and chronic neurological conditions, or those who have undergone surgery or radiotherapy to the upper aero-digestive tract, are at high risk of developing dysphagia ¹.