Interventions to prevent aspiration pneumonia in older adults: an updated systematic review

• Autor(a) principal: Santos, Joana Mafalda Lopes Grosso dos
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10773/27950
• topic: Aspiration pneumonia; Prevention and control; Older people; Dysphagia; Sistematic reviews

Introduction: Aspiration Pneumonia is an acute respiratory infection that results from the entry of fluids (liquids, saliva, secretions) and/or food with pathogenic bacteria into the lungs. Its prevalence increases with aging and it is correlated with neurological diseases, gastroesophageal reflux and Chronic Obstructive Pulmonary Disease. Consequently, it has been significantly associated with high rates of hospital readmission, increased length of stay, morbidity and mortality, and with decreased quality of life and increased health costs. Some of its risk factors are modifiable, so it is essential to evaluate the effect of preventive interventions to support clinical practice. Objectives: To review randomised controlled trials focusing on the study of interventions to prevent aspiration pneumonia in older adults. Methodology: A systematic literature review was performed using the protocol registered in PROSPERO. Randomised controlled trials of interventions to reduce the incidence of aspiration pneumonia in individuals older than 65 years, published between January 2002 and July 2019 and written in English, were included. Studies on postoperative pneumonia were excluded. Two reviewers using the Cochrane Collaboration’s tool for assessing risk of bias independently assessed the methodological quality of the studies. Results: Of the 629 articles identified, thirteen met the eligibility criteria and were included in the review. Six studies analysed pharmacological interventions, three articles addressed dietary interventions and compensatory strategies, one study evaluated an oral hygiene technique, two studied the effect of multidisciplinary interventions and one focused on a rehabilitation technique. Of the included studies, five had a positive and statistically significant effect. The methodological quality of most studies was assessed at high or unclear overall risk of bias. Conclusions: The most recent studies on interventions to prevent aspiration pneumonia in the elderly revealed poor methodological quality, making it difficult to define evidence-based strategies for clinical practice. Given the burden of aspiration pneumonia on patients and healthcare systems, the development of more rigorous clinical trials is warranted.