Multidisciplinary interventions for the prevention of aspiration pneumonia in super-aged societies: A scoping review

Aspiration pneumonia is associated with significant morbidity and is a leading cause of mortality among older adults, with a disproportionately high burden in super-aged societies such as Japan. Despite international guidelines recommending a multidisciplinary team (MDT) approach, evidence supporting collaborative interventions remains fragmented. We conducted a scoping review, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, to map multidisciplinary interventions for aspiration pneumonia prevention. MEDLINE, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature were searched through December 2024 for studies involving three or more healthcare disciplines. Among the 309 identified studies, 10 met the inclusion criteria. All included studies targeted primary prevention in high-risk populations; none addressed recurrence prevention, despite 30-day recurrence rates reaching approximately 30%. MDTs consistently included physicians, nurses, and speech-language pathologists, whereas pharmacists (2/10) and dental professionals (2/10) were relatively underrepresented, despite robust evidence supporting interventions within these professional domains. Seven studies reported a significant reduction in the incidence of aspiration pneumonia; however, the only randomized controlled trial showed no effect on pneumonia. The current evidence base, predominantly comprising observational and quality improvement studies, should be interpreted as preliminary and heterogeneous in terms of study design and outcome measurement. Evidence gaps remain in secondary and tertiary prevention and optimal team composition. Future trials in patients with prior aspiration pneumonia should investigate whether incorporation of professionals from disciplines with established intervention effectiveness, such as pharmacists and dental professionals, into MDTs translates into improved aspiration pneumonia outcomes.