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

Key summary points: Aim: We performed a scoping review to investigate the necessary clinical competencies for the management of AP in older adults, to serve as a baseline for multidisciplinary healthcare professionals to improve how they work with AP in the clinical, educational, and research settings. Findings: The clinical competencies for the management of aspiration pneumonia in older adults that were identified are summarized in the phrase 'Diagnose, Treat, and SUPPORT', where SUPPORT is an acronym for Swallow and nutrition intervention, Underlying condition management, Prognosis evaluation and decision making, Prevention and palliation, Oral management, Rehabilitation, and Team approach. Message: There is a particular demand for research and education in the area of supportive therapy for AP. 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. [ABSTRACT FROM AUTHOR]