IOPI Medical Q2 2024 Newsletter - OSA Research, Sleep 2024, and a New Distributor!

Spring appears to be off to a slow, sleepy start in our neck of the woods. It wants to come out and play, but then seems just as happy to roll back over and snooze for just a little bit longer. Here at IOPI, we do not have that luxury, and isn’t it wonderful!

Whether it’s branching out into a new market, continuing to grow our global distributor network, or working with you, our faithful customers, there is no time to waste on that snooze button!

Read on to see what we’ve been up to and don’t forget to visit our website. It offers the latest news and research and gives you the opportunity to interact with our IOPI staff, and Patient Advocacy tools (have you seen the Dysphagia Cost tool?!). You can also use our Get a Quote page if you’re in need of pricing information. It’s quick and easy!

You can also follow us on Instagram (iopimedical) and Facebook (IOPI Medical LLC) for the latest news and information.

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Yes, you read that correctly. IOPI Medical is now in the sleep market! Recent research has shown there are benefits of using the IOPI to combat obstructive sleep apnea (OSA).
Obstructive sleep apnea (OSA) is a widespread problem. The estimated prevalence is approximately 22% in males and 17% in females (Franklin & Lindberg, 2015). Researchers and clinicians are increasingly using the IOPI to assess and treat OSA.

Although more data is needed, the preliminary findings of multiple studies indicate the benefits of the IOPI for individuals suffering from OSA. IOPI is excited about the possibility of offering hope to the millions suffering from OSA.

A new market also gives us the opportunity to get out there and meet new faces. This time it is taking us to the Sleep 2024 conference in Houston, June 1-5.

At IOPI Medical, we have worked hard to help as many people as possible by getting the IOPI into the hands of those who need it. One way we do that is by growing our distributor network. With the addition of Qish Medical in Qatar, we now have 18 distributors, covering 27 countries with more on the horizon.

Fun fact, you can’t just ship to anyone, anywhere simply because there is a need, and you want to! It doesn’t matter how great you think your product is. There are regulatory rules for us here in the US, but also for any country we sell in. And they are ALL different.

As you may know, or at least guessed, when it comes to regulatory, being a medical device manufacturer is not easy, and the path to regulatory compliance certainly isn’t a quick one. But we are nothing if not persistent. That is why we have dedicated so much time to returning to the EU. While we have a strong presence there, and our distributors are patiently waiting for our return, a major overhaul of regulations, meant we had to leave for longer than we would like in order to make sure all necessary requirements are met in the correct way. Could we have cut corners and sped up the process? Perhaps. Some certainly do. But that is not who we are. We hold ourselves, and our products to an incredibly high-quality standard, so that you, our loyal customers, whether local or across the world, get the very best so that you may in turn may provide the best possible care to your patients.

Many of you may already be familiar with our esteemed Clinical Consultant, Ed Bice, but did you know, you can learn from him from the comfort of your office or home? IOPI Medical offers ASHA Continuing Education Units with our two FREE courses.

The Role of Oral Musculature in Swallowing and the Therapeutic Benefits of the IOPI, will review the oral musculature and its essential functions, as well as explore exercise principles and how the IOPI can be integrated into a dysphagia treatment plan.

Our second course, Research Update, summarizes recent findings related to the IOPI.

Click the button below to register!

Surveys of speech pathologists reveal that recommendations for altering diets and liquids are the most often used interventions (Jones et al., 2018; McCurtin et al., 2020; McCurtin & Healy, 2017; O'Keeffe, 2018). The articles included in the current newsletter investigate more recent findings on evidence surrounding modification of diets and liquids. Additionally, these studies investigate the possible side effects of this common intervention.

Jones, O., Cartwright, J., Whitworth, A., & Cocks, N. (2018). Dysphagia therapy post stroke: An exploration of the practices and clinical decision-making of speech-language pathologists in Australia. Int J Speech Lang Pathol, 20(2), 226-237. https://doi.org/10.1080/17549507.2016.1265588

McCurtin, A., Brady, R., Coffey, K., & O'Connor, A. (2020). Clarity and contradictions: speech and language therapists' insights regarding thickened liquids for post-stroke aspiration. International Journal of Therapy and Rehabilitation, 27, 1-15. https://doi.org/10.12968/ijtr.2019.0020

McCurtin, A., & Healy, C. (2017). Why do clinicians choose the therapies and techniques they do? Exploring clinical decision-making via treatment selections in dysphagia practice. Int J Speech Lang Pathol, 19(1), 69-76.
https://doi.org/10.3109/17549507.2016.1159333

O'Keeffe, S. T. (2018). Use of modified diets to prevent aspiration in oropharyngeal dysphagia: is current practice justified? BMC Geriatr, 18(1), 167. https://doi.org/10.1186/s12877-018-0839-7

Alterations and Preservations: Practices and Perspectives of Speech-Language Pathologists Regarding the Intervention of Thickened Liquids for Swallowing Problems

McCurtin, A., Byrne, H., Collins, L., McInerney, M., Lazenby-Paterson, T., Leslie, P., O'Keeffe, S., O'Toole, C., & Smith, A. (2024). Alterations and Preservations: Practices and Perspectives of Speech-Language Pathologists Regarding the Intervention of Thickened Liquids for Swallowing Problems. American journal of speech-language pathology, 33(1), 117–134.

The recent study aimed to investigate the impact of ongoing debates surrounding the efficacy and consequences of thickened liquids as a dysphagia treatment on the practices and perspectives of speech pathologists. Conducted through a web-based survey, the study recruited participants from Australia, New Zealand, the United Kingdom, and the United States, with 370 speech pathologists completing the survey. Most of the respondents had over a decade of experience and were working in hospital settings. The survey results revealed several key findings:

• Frequency of Recommendation: Only 20% of respondents reported frequently recommending thickened liquids, indicating a decrease in their use compared to previous practices.

• Perception of Burdensomeness: Despite some clinicians still recommending thickened liquids, a majority (61%) considered this treatment to be burdensome.

• Rationale for Recommendation: Clinicians who endorsed thickened liquids cited reasons such as believing it to be the best treatment option and claiming that it works. Their recommendations were often based on observations of laryngeal penetration, coughing, and personal clinical experience.

• Beliefs Regarding Effectiveness: Those advocating for thickened liquids were more likely to perceive their use as evidence-based, effective in reducing aspiration, and beneficial for improving hydration.

• Person-Centered Care: While person-centered care was deemed important among all respondents, a significant portion indicated they would implement thickened liquids even against patient wishes.

• Divergent Groups: The study identified two distinct groups of clinicians—those who frequently employ and believe in the efficacy of thickened liquids and those who do not.

• Influence of Current Debates: While ongoing debates regarding the use of thickened liquids seem to have influenced some practices, a considerable number of speech pathologists continue to recommend them.

These findings suggest a shift in the approach to thickened liquids among speech pathologists, with some embracing alternative treatment options. However, the persistence of a significant number of clinicians advocating for thickened liquids underscores the need for a reframing of perspectives on this intervention and exploration of alternative treatments for dysphagia.

Second Update of a Systematic Review and Evidence-Based Recommendations on Texture Modified Foods and Thickened Liquids for Adults (above 17 years) with Oropharyngeal Dysphagia

Hansen, T., Beck, A. M., Kjaersgaard, A., & Poulsen, I. (2022). Second update of a systematic review and evidence-based recommendations on texture modified foods and thickened liquids for adults (above 17 years) with oropharyngeal dysphagia. Clinical nutrition ESPEN, 49, 551–555.

https://doi.org/10.1016/j.clnesp.2022.03.039

The authors conducted a systematic review aiming to update clinical guidelines on recommending alterations to liquid and diet consistency for adults with dysphagia. The review assessed various outcomes including survival, quality of life, aspiration risk, pneumonia occurrence, dehydration, nutritional status, mealtime performance, patient preferences, and intervention adherence. Despite efforts to find new scientific evidence, the review only identified one new study, bringing the total number of randomized controlled trials (RCTs) to three. Unfortunately, the evidence from the included studies did not demonstrate convincing benefits of modified diets or liquids. The systematic review did not find sufficient evidence to support the use of thickened liquids or texture-modified diets for preventing death or pneumonia, improving quality of life, nutritional status, or oral intake in individuals with dysphagia.

Modified Medication Use in Dysphagia: The Effect of Thickener on Drug Bioavailability-A Systematic Review

Atkin, J., Devaney, C., Yoshimatsu, Y., & Smithard, D. (2024). Modified medication use in dysphagia: the effect of thickener on drug bioavailability-a systematic review. European geriatric medicine, 15(1), 19–31.

https://doi.org/10.1007/s41999-023-00896-6

The systematic review encompassed articles incorporating search terms related to dysphagia/thickened diet, as well as bioavailability or absorption of medicines or pharmacokinetics. The studies included in the review encompassed all genders and were conducted in various countries, involving individuals aged 18 years or older across community and hospital settings. Upon full-text review, 18 articles were deemed suitable for inclusion. Predominantly, the studies were conducted under laboratory conditions (in vitro) rather than involving subjects directly (in vivo). Furthermore, most studies were characterized as single-center, prospective studies. The findings of these studies indicated that thickeners generally impact the dissolution rates of medications. However, only a limited number of studies assessed bioavailability or employed clinical outcomes as metrics. Despite the consistency in findings across the reviewed studies, the authors suggest a need for further investigation through larger-scale studies. These future studies should aim to evaluate the therapeutic implications of thickener usage across a broader spectrum of medications. Additionally, they should consider other variables such as the type of thickener, viscosity, and duration of immersion, to provide a more comprehensive understanding of the impact of thickener use in dysphagia management.

The Adverse Effects and Events of Thickened Liquid Use in Adults: A Systematic Review

Werden Abrams, S., Gandhi, P., & Namasivayam-MacDonald, A. (2023). The Adverse Effects and Events of Thickened Liquid Use in Adults: A Systematic Review. American journal of speech-language pathology, 32(5), 2331–2350.

https://doi.org/10.1044/2023_AJSLP-22-00380

The review aimed to consolidate evidence regarding adverse events and effects stemming from the use of thickened liquids in adults. Across 33 studies encompassing 4,990 participants, various adverse events and effects were documented. These included adverse events such as dehydration, pneumonia, death, urinary tract infection, and hospitalization. Additionally, adverse effects noted were reduced quality of life, aspiration, reduced intake, increased residue, and reduced medication bioavailability. The findings underscore a spectrum of adverse outcomes linked to the usage of thickened liquids. Consequently, it is imperative for dysphagia research to monitor and report such adverse outcomes. Given the current body of research evidence, clinicians need to assess the potential negative outcomes against the anticipated benefits associated with the adoption of thickened liquids.

To help you achieve the greatest level of success for your patients, we continue to provide you with the necessary Purchasing Advocacy tools, as well as clinical support.

Our Purchasing Advocacy tools can be found on our Medical Professionals page. Here you will find our IOPI Dysphagia Cost Tool as well as a ready-to-use Benefits of IOPI for Dysphagia PowerPoint. Just populate it with information specific to your patient’s needs.

You also have clinical support at your fingertips. Our clinical consultant, Ed M. Bice, M.Ed., CCC-SLP, is available to mentor through the advocacy process to assess and report the estimated cost of dysphagia to your facility. You can reach Ed for a patient consultation or clinical question by calling (844) 844-IOPI or emailing ed@iopimedical.com.

To access our IOPI Dysphagia Cost Tool, the Benefits of IOPI for Dysphagia PowerPoint, and tips on advocating for your patients, please visit: https://iopimedical.com/purchasing-advocacy/