"Diagnose, Treat, and SUPPORT". Clinical competencies in the management of older adults with aspiration pneumonia: a scoping review.

Yuki Yoshimatsu, Yoichi Ohtake, Mamiko Ukai, Taiju Miyagami, Toru Morikawa, Yoshinosuke Shimamura, Yuki Kataoka, Tadayuki Hashimoto

Journal: European geriatric medicine 2024;15(1):57-66

PMID: 38060164

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Abstract

BACKGROUND

Aspiration pneumonia in older adults is increasingly common, with a high care burden and morbidity. However, clinical competencies in its management have not been developed, and healthcare professionals struggle on how to care for these patients with multimodal treatment needs. Therefore, we conducted a scoping review to investigate what is known about the desired clinical competencies for the management of older adults with aspiration pneumonia, to utilise in clinical practice, education, and future research.

METHODS

First, we defined aspiration pneumonia according to a preliminary search. We then searched the literature on MEDLINE and CINAHL, focusing on studies involving patients aged 65 years old and older diagnosed with aspiration pneumonia. All settings were included, with the exception of intensive care units. Publication dates were limited to January 2011 to July 2022 and languages to English and Japanese. The extracted data were used to refine the preliminary competency framework developed by the Japan Aspiration pneumonia inter-Professional team Educational Program (JAPEP) in preparation of this study.

RESULTS

Ninety-nine studies were included. Following data extraction from these studies, 3 competencies were renamed, and 3 new competencies were added, to create a list of 12 competencies. These were Diagnosis, Treatment, Swallow Assessment, Underlying condition management, Nutrition, Oral management, Rehabilitation, Multidisciplinary team, Decision making, Prevention, Prognosis, and Palliative care.

CONCLUSIONS

Our scoping review identified 12 clinical competencies required in the management of older adults with aspiration pneumonia, outlined in the phrase 'Diagnose, Treat and SUPPORT'. We encourage healthcare professionals to share these competencies as a team to identify areas of unmet need and improve their patient care, with an emphasis on supportive care.

Address: Elderly Care, Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, Stadium Rd, London, SE18 4QH, UK. [email protected].; Centre for Exercise Activity and Rehabilitation, School of Human Sciences, University of Greenwich, London, UK. [email protected].; Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan. [email protected].; Department of Internal Medicine, Imai Hospital, Hyogo, Japan.; Department of Family Medicine, Kameda Family Clinic, Tateyama, Japan.; Department of Health Data Science, Yokohama City University, Kanagawa, Japan.; Faculty of Medicine, Department of General Medicine, Juntendo University, Bunkyo City, Japan.; Department of General Medicine, Nara City Hospital, 1-50-1, Higashikideracho, Nara, 630-8305, Japan.; Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan.; Department of Nephrology, Teine Keijinkai Medical Center, 1-40, Maeda 1-12, Teine, Sapporo, Hokkaido, 006-8555, Japan.; Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Tanaka Asukai-cho 89, Sakyo-ku, Kyoto, 606-8226, Japan.; Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.; Department of Healthcare Epidemiology, Graduate School of Medicine/Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.; Department of General Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.

DOI: 10.1007/s41999-023-00898-4

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https://doi.org/10.1007/s41999-023-00898-4

MeSH Terms: Humans, Aged, Clinical Competence, Prognosis, Health Personnel, Pneumonia, Aspiration, Japan