Objective: To evaluate dysphagia recognition and management in Parkinson’s patients admitted to Royal Berkshire Hospital (RBH),Reading,UK according to National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report 2021 recommendations.

Background: Dysphagia is inevitable in Parkinson’s and is a disease progression marker.Drooling of saliva can be the first sign of dysphagia and is often not reported.Lack of patient awareness and under recognition of dysphagia by health care professionals can put patients at risk of malnutrition,dehydration,and chest infections.The NCEPOD report 2021 made the following recommendations for Parkinson’s patients admitted to acute hospital:
1- Document the swallow status of all patients with Parkinson’s at the point of referral to hospital.
2- Screen patients with Parkinson’s for swallowing difficulties at admission (ask questions about swallowing difficulties, drooling and recurrent pneumonia).
3-Refer patients with Parkinson’s who have swallowing difficulties (or communication problems) to speech and language therapy(SALT)

Method: Parkinson’s patients admitted to RBH between June and September 2021 were identified by medical informatics and data on above-mentioned recommendations  was collected from Electronic Patient Record.

Results: 30 patients (20 males) with average age of 82 years were reviewed.Presenting complaints were fall 37%(11/30),abdominal pain13%(4/30),pneumonia 7%(2/30) and dysphagia 3%(1/30).67% (20/30) patients were referred by emergency services,4%by GP(General Practitioner,10%(3/30)by other clinicians and 10%(3/30)were self referrals.Swallowing status was not documented in any GP referral.Breakdown of dysphagia screening is shown in Table1.
In the relevant cohort SALT referral was done for 44% (8/18)patients.

Conclusion: Three screening questions for dysphagia (swallowing impairment (77%), sialorrhea (97%) and recurrent pneumonias (100%) are not being asked. Most referrals are from emergency services and none of the GP referrals have swallowing status documented. MUST score within 6 hours is documented in 17%(5/30) patients.A working MDT group(doctors, Parkinson’s nurses,SALT, physiotherapist, occupational, pharmacist and dietician)has been established to organise teaching for staff about screening, assessment and management of dysphagia in Parkinson’s in line with the NCEPOD recommendations.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/audit-of-dysphagia-care-provided-to-parkinsons-patients-during-acute-hospital-admission/