Transcutaneous neuromuscular electrical stimulation for oropharyngeal dysphagia in adults

Current evidence on transcutaneous neuromuscular electrical stimulation for oropharyngeal dysphagia in adults shows there are no major safety concerns.

• For adults with dysphagia after a stroke, the evidence on efficacy suggests a potential benefit, but is limited in quality and quantity. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research.Find out what special arrangements mean on the NICE interventional procedures guidance page.

• For adults with dysphagia not caused by a stroke, there is insufficient evidence on efficacy to support the use of this procedure. Therefore, this procedure should only be used in the context of research. Find out what only in research means on the NICE interventional procedures guidance page.

Clinicians wishing to do transcutaneous neuromuscular electrical stimulation for adults with oropharyngeal dysphagia after a stroke should:

• Inform the clinical governance leads in their NHS trusts.

• Ensure that patients understand the procedure's safety and efficacy, as well as any uncertainties about these and provide them with clear written information to support shared decision making. In addition, the use of NICE's information for the public on transcutaneous neuromuscular electrical stimulation is recommended.

• Audit and review clinical outcomes of all patients having transcutaneous neuromuscular electrical stimulation for oropharyngeal dysphagia. NICE has identified relevant audit criteria and has developed NICE's interventional procedure outcomes audit tool (which is for use at local discretion).

Further research on transcutaneous neuromuscular electrical stimulation for oropharyngeal dysphagia in adults should address patient selection, variations in technique, the need for retreatments and long-term outcomes.