{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:08:35Z","timestamp":1791994115356,"version":"4.4.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T00:00:00Z","timestamp":1706313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T00:00:00Z","timestamp":1706313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Geriatr Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Dysphagia is associated with long-term conditions including strokes, dementia, Parkinson\u2019s disease and frailty. Dysphagia affects 30\u201340% of the population aged over 65\u00a0years-old. Adults with dysphagia often experience long-term conditions requiring multiple medications (often\u2009&gt;\u20095) to manage these. The thickening of liquids is a common compensatory strategy in dysphagia management. Studies suggest that immersion in thickened liquids affects medicines\u2019 solubility in vitro. Clinicians and pharmacists are unaware of the pharmacokinetic\/therapeutic effects of thickened liquids on oral medicines. We conducted a systematic review of existing literature on thickeners\u2019 effects on drug bioavailability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>We performed a literature search of MEDLINE &amp; EMBASE. Search terms included: dysphagia\/thickened diet (EMBASE only)\/ bioavailability or absorption of medicines or pharmacokinetics; excluded: NG feeds\/animal studies. Studies included: all genders, countries,\u2009&gt;\u200918\u00a0years, community and hospital settings. PRISMA guidance was followed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five hundred seventy results were found, and 23 articles identified following the reference list review. Following an abstract and full-text review, 18 were included. Most articles evaluated thickeners on dissolution profiles in-vitro, with a few investigating in-vivo. Most studies were single-centre prospective studies identifying that thickeners generally affect dissolution rates of medications. Few studies assessed bioavailability or used clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Dysphagia and polypharmacy are common in older adults, but little is known about the effects of altering liquid viscosity on the therapeutic effect of most medications. Further larger-scale studies are required to evaluate the therapeutic impact of thickener, on a bigger range of medications, factoring in other variables such as type of thickener, viscosity of thickener and duration of immersion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s41999-023-00896-6","type":"journal-article","created":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T11:02:13Z","timestamp":1706353333000},"page":"19-31","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Modified medication use in dysphagia: the effect of thickener on drug bioavailability\u2014a systematic review"],"prefix":"10.1007","volume":"15","author":[{"given":"Jayne","family":"Atkin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6692-7290","authenticated-orcid":false,"given":"Christopher","family":"Devaney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0913-3507","authenticated-orcid":false,"given":"Yuki","family":"Yoshimatsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6863-3099","authenticated-orcid":false,"given":"David","family":"Smithard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,27]]},"reference":[{"key":"896_CR1","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1007\/s41999-021-00479-3","volume":"12","author":"F Pazan","year":"2021","unstructured":"Pazan F, Wehling M (2021) Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. 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