Summary of the Systematic Review

Article Citation

Implementing the Free Water Protocol Does Not Result in Aspiration Pneumonia in Carefully Selected Patients With Dysphagia: A Systematic Review

Gillman, A., Winkler, R., et al. (2017).
Dysphagia, 32(3), 345-361.
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Article Quality Ratings

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Indicators of Review Quality

  • Yes The review states a clearly focused question/aim.
  • Yes Criteria for inclusion of studies are provided.
  • Yes Search strategy described in sufficient detail for replication.
  • Yes Included studies are assessed for study quality.
  • Yes Quality assessments are reproducible.
  • Yes Characteristics of the included studies are provided.

Article Details

Description

This is a systematic review and meta-analysis of current literature on the implementation and effects of the Frazier Free Water Protocol.

Questions/Aims Addressed

Summary and appraisal of current literature on implementation of the Free Water Protocol

Population

"Patients with oropharyngeal dysphagia at risk of aspiration on thin liquids" (p. 347)

Intervention/Assessment

Free Water Protocol

Number of Studies Included

8

Years Included

Up to July 2016


Conclusions from This Systematic Review

What are Conclusions?

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Treatment

In general, more favorable outcomes regarding quality of life were reported after implementation of the Free Water Protocol.

Keywords: Diet Modification

Eight studies were included in the review, five of which were randomized controlled trials. Results indicated that "adult rehabilitation inpatients without degenerative neurological conditions and with relatively intact mobility and cognition (or who could receive the required assistance to compensate for a cognitive impairment) did not develop lung complications when the Free Water Protocol was implemented" (p. 357). Low-level evidence suggested fluid intake may have increased. The importance of adherence to guidelines of the Free Water Protocol, including thorough oral care and interdisciplinary training (full outline of guidelines in Table 2, p. 348), was emphasized. 

Keywords: Adults, Diet Modification, Education/Training (includes Oral Hygiene), Dysphagia

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Assessment

Eight studies were included in the review, five of which were randomized controlled trials. Results indicated that "adult rehabilitation inpatients without degenerative neurological conditions and with relatively intact mobility and cognition (or who could receive the required assistance to compensate for a cognitive impairment) did not develop lung complications when the Free Water Protocol was implemented" (p. 357). Low-level evidence suggested fluid intake may have increased. The importance of adherence to guidelines of the Free Water Protocol, including thorough oral care and interdisciplinary training (full outline of guidelines in Table 2, p. 348), was emphasized. 

Keywords: Adults, Diet Modification, Education/Training (includes Oral Hygiene), Dysphagia

Notes on This Article

Adapted/modified versions of the Frazier Free Water Protocol were included based on a list of necessary elements for such protocols, provided in Table 2.

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