Priority 28 from the Palliative and end of life care PSP

UNCERTAINTY:  What are the best ways to manage the problems associated with difficulty in swallowing, including drooling and excessive salivation, for patients with Parkinson's disease, motor neurone disease (MND) and dementia who are at the end of their life?    (JLA PSP Priority 28)
Overall ranking 28
JLA question ID 0026/28
Evidence

Dai Y, Li C, Xie Y, Liu X, Zhang J, Zhou J, Pan X, Yang S. Interventions for dysphagia in oesophageal cancer. Cochrane Database of Systematic Reviews 2014, Issue 10. Art. No.: CD005048. DOI: 10.1002/14651858.CD005048.pub4

Flynn EP, Smith CH, Walsh CD, Walshe M. Modifying the consistency of food and fluids for swallowing difficulties in dementia (Protocol). Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD011077. DOI: 10.1002/14651858.CD011077.

Sampson EL, Candy B, Jones L. Enteral tube feeding for older people with advanced dementia. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD007209. DOI: 10.1002/14651858.CD007209.pub2.   

Katzberg HD, Benatar M. Enteral tube feeding for amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database of Systematic Reviews 2011, Issue 1. Art. No.: CD004030. DOI: 10.1002/14651858.CD004030.pub3

Ongoing trialA multicenter, prospective feasibility follow-up study to evaluate a fully covered stent with new antimigration properties for the palliation of malignant dysphagia: HANARO study  http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3313

Health Research Classification System category  Generic
Extra information provided by this PSP
Original uncertainty examples How to balance providing fluids to those who are dying who cannot swallow safely or easily?
Submitted by Professionals x 2  ~  Carer x 1     
Outcomes to be measured Patient Satisfaction; health related quality of life; health related cost.
PSP information
PSP unique ID 0026
PSP name Palliative and end of life care
Total number of uncertainties identified by this PSP. 83  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 21 November 2014