American Speech-Language-Hearing Association

EBP Compendium: Summary of Systematic Review

Canadian Institute of Health Research
Interventions to Prevent Aspiration Pneumonia in Older Adults: A Systematic Review

Loeb, M. B., Becker, M., et al. (2003).
Journal of the American Geriatrics Society, 51(7), 1018-1022.

Indicators of Review Quality:

The review addresses a clearly focused question No
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality Yes
Quality assessments are reproducible No

Description: This is a systematic review of randomized clinical trials addressing the effects of interventions to prevent aspiration pneumonia (AP) in older adults.

Question(s) Addressed:

Question not specifically stated. 

Population: Patients 65 years or older who were at risk for aspiration based on documented oropharyngeal dysphagia, previous stroke, previous aspiration or tube feeding.

Intervention/Assessment: Dietary intervention, compensatory strategy, pharmacologic therapies, oral hygene, or feeding tubes.

Number of Studies Included: 8

Years Included: 1966 - 2001

Findings:

  

Conclusions:

  • Treatment
    • Swallowing
      • Diet Modification - This review suggests that there are few clinical trials supporting the use of alteration in diet consistency to reduce aspiration pneumonia and methodological limitations reduce confidence in their findings. Additional trials are needed.
      • Positioning - Few data exist to support positioning strategies such as the chin tuck, upright position following meals, and semirecumbent position to prevent aspiration in high risk older adults. Insufficient power impacted the ability to determine a difference between groups in one study. Additional studies are needed with larger numbers of patients to determine the effects of positioning.

Keywords: Swallowing Disorders, Diet Modification, Maneuvers (Swallowing), Positioning (Swallowing), Tube Feeding

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Added to Compendium: January 2012

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