British Thoracic Society publishes two new Clinical Statements: The BTS Clinical Statement on aspiration pneumonia and the BTS Clinical Statement on community acquired pneumonia in people with learning disability.

Today the British Thoracic Society (BTS) publishes two novel pieces of guidance on pneumonia. The first is the BTS Clinical Statement on aspiration pneumonia, and the second is the BTS Clinical Statement on community acquired pneumonia in people with learning disability.

Aspiration pneumonia (AP) is inflammation and infection of the lungs caused by food or liquid being breathed into the lungs, instead of being swallowed. This differs from Community Acquired Pneumonia (CAP), which is largely caused by breathing in pathogens such as bacteria or viruses.  Community acquired pneumonia is a major cause of death and a significant contributor to the increased risk of hospital admission observed in people with learning disability.

BTS has established the two Clinical Statements, which specifically cross-reference each other, in order to help reduce the knowledge gap in this important area and provide practical guidance for clinicians and patients alike.

Martin Allen, Interim National Clinical Director for Respiratory Medicine said on the commissioning of the two statements,

“The learning from deaths reviews in patients with learning disability and autism (LeDeR) show a high morbidity and mortality from aspiration and community acquired pneumonia.  These two articles are thus a welcome addition to optimising the care for these individuals from both a clinical and holistic perspective.”

The two Clinical Statements also align with the value BTS places on addressing health inequalities, with both AP and CAP being significant drivers of morbidity and mortality in more vulnerable groups within the UK. Those affected are often people with learning disability, older people, those of lower socio-economic status, those who have other co-morbidities, or a weakened immune system.

Dr Julian Legg, lead author of the BTS Clinical Statement on the prevention and management of community acquired pneumonia in people with learning disability, said,

“People with learning disability are at increased risk of morbidity and mortality from community acquired pneumonia because of multiple factors including underlying medical conditions and communication barriers. By recognising this risk, healthcare providers can take appropriate steps to ensure timely risk factor recognition, diagnosis and treatment, and work with patients, families and carers to implement pertinent, preventative measures.”

These Clinical Statements offer practical guidance by addressing key considerations in the prevention, diagnosis and management of AP and CAP. The guidance was based on the published evidence available and corroborating expert opinion.

Lead author of the BTS Clinical Statement on Aspiration Pneumonia, Professor John Simpson, said,

“Aspiration pneumonia is a common and important clinical problem, particularly in older patients and in people with learning disability. Because there are excellent guidelines on community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), and because aspiration contributes to the development of CAP and HAP, aspiration pneumonia has perhaps become the Cinderella of pneumonia. 

We hope this Statement will raise the profile of, and increase interest in, aspiration pneumonia. Throughout, we have tried to emphasise the importance of preventing aspiration pneumonia, and to stress the value of an interdisciplinary approach to management.”   

The Clinical Statements are important pieces of work that aim to strengthen the knowledge base in AP and CAP care. Each statement establishes practical action points and highlights outstanding gaps in knowledge with the aim of encouraging best practice and further quality research in the future.

BTS Chair Paul Walker said,

“Some of the most important learning from Covid-19 concerned the management of pneumonia in people with disability, including learning disability. We hope these clinical statements will lead to improvement in care both in people with learning disability and a wider group of people with pneumonia.”   

Access to the BTS Clinical Statement on aspiration pneumonia is available here.

Access to the BTS Clinical Statement on community acquired pneumonia in people with learning disability is available here.

Access to the webinar is available here.