The Difference between Ideal and Actual Fasting Duration in the Treatment of Patients with Aspiration Pneumonia: A Nationwide Survey of Clinicians in Japan

Abstract

In Japan, aspiration pneumonia is common among the elderly and patients are often treated by temporary discontinuation of meals. However, there are few published studies on the fasting duration for aspiration pneumonia treatment. Therefore, we conducted the present study to assess the opinions of clinicians regarding the fasting duration for the treatment of patients with aspiration pneumonia and the actual medical practice with regard to oral ingestion in hospitalized patients with aspiration pneumonia. We targeted hospitals with internal medicine and respiratory medicine departments across Japan. A questionnaire regarding the fasting duration for aspiration pneumonia treatment and oral ingestion in hospitalized patients with aspiration pneumonia was mailed to physicians treating patients with pneumonia at 2,490 hospitals. We received appropriate responses from 350 facilities (response rate, 14.1%). Most clinicians (78.3%) responded that it best to keep the fasting duration for treatment as short as possible and considered that fasting is absolutely unnecessary. Regarding oral ingestion in hospitalized patients, more than 25% of clinicians restricted oral intake for a certain number of days. The majority of these clinicians (53.3%) preferred prolonged fasting for 3 to 7 days. Although most physicians preferred the fasting duration to be as short as possible, there was a difference between the ideal and actual scenarios in reintroducing oral intake early in patients with aspiration pneumonia. Improving physicians' knowledge and experience will bridge the gap between the ideal situation and what currently occurs. Further studies should investigate the acceptable fasting duration for the treatment of aspiration pneumonia.

A comparison of pneumonia care quality between general physicians and pulmonologists

“…Returning the administered questionnaire was considered as consent to participate by the participants. Details regarding fasting duration and resumption of oral intake following aspiration pneumonia have been published previously …”

Physicians’ opinions regarding the criteria for resuming oral intake after aspiration pneumonia: A questionnaire survey and cluster analysis of hospitals across Japan

“…Furthermore, our research has shown that 89.4% of medical institutions implemented short‐term fasting while treating patients with aspiration pneumonia . However, the resumption of oral intake is critical to the quality of life and likelihood of recurrence among patients with aspiration pneumonia .…”

“…9 Furthermore, our research has shown that 89.4% of medical institutions implemented short-term fasting while treating patients with aspiration pneumonia. 11 However, the resumption of oral intake is critical to the quality of life and likelihood of recurrence among patients with aspiration pneumonia. 3 Nevertheless, the factors that are used to determine the timing of oral intake resumption have not been discussed, and this timing is typically based on the attending clinician's judgment and experience.…”

Cooperation between Single-Handed and Group Practices Ensures the Replacement of Gastrostomy Tubes and Tracheal Cannulas in Home Medical Care Settings

“…It is reported that in Japan the average response rate is 21.3% in mail-in and unpaid surveys without reminder like the present study (Hagihara et al 2006), and that might give a hint to the reason for the low response rate in physicians. On the other hand, there is a report that the response rate was less than 15% (Kenzaka et al 2016) and, therefore, the response rate of the present study is considered to represent physicians above a certain level.…”