Evidence-Based Measures for Preventing Aspiration Pneumonia in Patients with Dysphagia

Abstract

Dysphagia increases the risk of aspiration pneumonia with resultant morbidity and recurrent hospital admissions. With a rapidly ageing population and an increasing complex chronic disease burden, the prevalence of patients with dysphagia will increase. Family physicians will encounter more patients with dysphagia in various practice settings of primary, intermediate long term care and tertiary settings. We conducted a comprehensive literature review on the latest established evidence on measures to prevent aspiration pneumonia in patients with dysphagia. We found that many studies involved only small numbers of patients and lacked the methodological quality of well-conducted randomised contolled trials. Interventions that showed strongest evidence in preventing aspiration pneumonia were good oral health and the use of Angiotensin Converting Enzyme (ACE) inhibitor. We have provided a summary of key recommendations for family physicians, based on the Scottish Intercollegiate Guidelines Network (SIGN) framework in order to reflect the latest evidence-based strategies on measures to prevent aspiration pneumonia in patients with dysphagia.