{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T17:01:53Z","timestamp":1793898113150,"version":"4.8.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T00:00:00Z","timestamp":1715212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T00:00:00Z","timestamp":1715212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009098","name":"Japanese Respiratory Society","doi-asserted-by":"publisher","award":["2021"],"award-info":[{"award-number":["2021"]}],"id":[{"id":"10.13039\/501100009098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000625","name":"The Great Britain Sasakawa Foundation","doi-asserted-by":"crossref","award":["B149"],"award-info":[{"award-number":["B149"]}],"id":[{"id":"10.13039\/501100000625","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Geriatr Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Older patients with pneumonia are commonly restricted from oral intake due to concerns towards aspiration. Eating and drinking with acknowledged risks (EDAR) is a shared decision-making process emphasising patient comfort. As part of our project to find the barriers and facilitators of EDAR, we aimed for this initial study to see how frequently EDAR was selected in practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study at an acute hospital where EDAR was initially developed, of patients aged\u2009\u2265\u200975\u00a0years-old admitted with pneumonia and referred to speech and language therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 216 patients, EDAR decisions were made in 14.4%. The EDAR group had a higher 1-year mortality than the modified\/normal diet groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Pneumonia recurrence rate did not differ significantly between the groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.070).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EDAR decisions were comparatively less common and most were associated with end-of-life care. Underlying reasons for the low EDAR application rate must be investigated to maximise patient autonomy and comfort as intended by EDAR while minimising staff burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s41999-024-00983-2","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T11:02:17Z","timestamp":1715252537000},"page":"771-775","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Decisions on eating and drinking in older adults admitted with pneumonia and referred for swallowing difficulties"],"prefix":"10.1007","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0913-3507","authenticated-orcid":false,"given":"Yuki","family":"Yoshimatsu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1137-9728","authenticated-orcid":false,"given":"Dharinee","family":"Hansjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4652-3168","authenticated-orcid":false,"given":"Marianne","family":"Markowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3497-3137","authenticated-orcid":false,"given":"Ryan","family":"Essex","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6863-3099","authenticated-orcid":false,"given":"David G.","family":"Smithard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,9]]},"reference":[{"issue":"17","key":"983_CR1","doi-asserted-by":"publisher","first-page":"5214","DOI":"10.3390\/jcm11175214","volume":"11","author":"Y Yoshimatsu","year":"2022","unstructured":"Yoshimatsu Y, Smithard DG (2022) A paradigm shift in the diagnosis of aspiration pneumonia in older adults. J Clin Med. 11(17):5214","journal-title":"J Clin Med."},{"issue":"5","key":"983_CR2","doi-asserted-by":"publisher","first-page":"115","DOI":"10.3390\/geriatrics7050115","volume":"7","author":"DG Smithard","year":"2022","unstructured":"Smithard DG, Yoshimatsu Y (2022) Pneumonia, aspiration pneumonia, or frailty-associated pneumonia? Geriatrics (Basel). 7(5):115","journal-title":"Geriatrics (Basel)."},{"issue":"5","key":"983_CR3","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1016\/j.clnu.2015.09.011","volume":"35","author":"K Maeda","year":"2016","unstructured":"Maeda K, Koga T, Akagi J (2016) Tentative nil per os leads to poor outcomes in older adults with aspiration pneumonia. Clin Nutr 35(5):1147\u20131152","journal-title":"Clin Nutr"},{"key":"983_CR4","unstructured":"D. Hansjee, N. Burch, L. Campbell, H. Crawford, Crowder R, D. Garrett, et al 2021 Eating and drinking With acknowledged risks: multidisciplinary team guidance for the shared decision-making process (adults) [Working Paper] London UK"},{"issue":"4","key":"983_CR5","doi-asserted-by":"publisher","first-page":"e344","DOI":"10.7861\/clinmed.2021-0161","volume":"21","author":"K Porter","year":"2021","unstructured":"Porter K, Burch N, Campbell C, Danbury C, Foster C, Gabe S, Goddard A, Harp K, Holdoway A, Hughes T, Le Ball K (2021) Supporting people who have eating and drinking difficulties. Clinical med 21(4):e344","journal-title":"Clinical med"},{"key":"983_CR6","doi-asserted-by":"publisher","DOI":"10.3233\/ACS-210031","author":"ST O\u2019Keeffe","year":"2021","unstructured":"O\u2019Keeffe ST, Murray A, Leslie P, Collins L, Lazenby-Paterson T, McCurtin A et al (2021) Aspiration, risk and risk feeding: a critique of the royal college of physicians guidance on care of people with eating and drinking difficulties. Adv Commun Swallowing. https:\/\/doi.org\/10.3233\/ACS-210031","journal-title":"Adv Commun Swallowing."},{"issue":"5","key":"983_CR7","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1503\/cmaj.050051","volume":"173","author":"K Rockwood","year":"2005","unstructured":"Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I et al (2005) A global clinical measure of fitness and frailty in elderly people. CMAJ 173(5):489\u2013495","journal-title":"CMAJ"},{"issue":"4","key":"983_CR8","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1056\/NEJM199701233360402","volume":"336","author":"MJ Fine","year":"1997","unstructured":"Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE et al (1997) A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med 336(4):243\u2013250","journal-title":"N Engl J Med"},{"key":"983_CR9","unstructured":"Social Science Statistics. https:\/\/www.socscistatistics.com\/."},{"issue":"4","key":"983_CR10","doi-asserted-by":"publisher","first-page":"65","DOI":"10.3390\/geriatrics3040065","volume":"3","author":"D Hansjee","year":"2018","unstructured":"Hansjee D (2018) An acute model of care to guide eating & drinking decisions in the frail elderly with dementia and dysphagia. Geriatrics (Basel). 3(4):65","journal-title":"Geriatrics (Basel)."},{"issue":"2","key":"983_CR11","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1007\/s41999-023-00929-0","volume":"15","author":"Y Yoshimatsu","year":"2024","unstructured":"Yoshimatsu Y, Thomas H, Thompson T, Smithard DG (2024) Prognostic factors of poor outcomes in pneumonia in older adults: aspiration or frailty? European Geriatric Medicine. 15(2):481\u2013488","journal-title":"European Geriatric Medicine."},{"key":"983_CR12","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afae012","author":"Y Yoshimatsu","year":"2024","unstructured":"Yoshimatsu Y, Kragholm K, Clemmensen SZ, Melgaard D, Torp-Pedersen C, Smithard DG et al (2024) The predictive value of anticholinergic drug exposure and the outcome of pneumonia: a danish database study. Age Ageing. https:\/\/doi.org\/10.1093\/ageing\/afae012","journal-title":"Age Ageing."},{"issue":"1","key":"983_CR13","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s41999-023-00898-4","volume":"15","author":"Y Yoshimatsu","year":"2023","unstructured":"Yoshimatsu Y, Ohtake Y, Ukai M, Miyagami T, Morikawa T, Shimamura Y et al (2023) Diagnose, Treat, and SUPPORT clinical competencies in the management of older adults with aspiration pneumonia: a scoping review. Eur Geriatr Med 15(1):57\u201366","journal-title":"Eur Geriatr Med"},{"issue":"1","key":"983_CR14","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s12910-023-00885-1","volume":"24","author":"ST O'Keeffe","year":"2023","unstructured":"O\u2019Keeffe ST, Leslie P, Lazenby-Paterson T, McCurtin A, Collins L, Murray A et al (2023) Informed or misinformed consent and use of modified texture diets in dysphagia. BMC Med Ethics 24(1):7","journal-title":"BMC Med Ethics"},{"issue":"3","key":"983_CR15","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1055\/s-0040-1710561","volume":"41","author":"P Leslie","year":"2020","unstructured":"Leslie P, Lisiecka D (2020) Ethical issues in dysphagia management. Semin Speech Lang 41(3):257\u2013265","journal-title":"Semin Speech Lang"},{"issue":"4","key":"983_CR16","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1093\/ageing\/afz027","volume":"48","author":"A Murray","year":"2019","unstructured":"Murray A, Mulkerrin S, O\u2019Keeffe ST (2019) The perils of \u201crisk feeding.\u201d Age Ageing 48(4):478\u2013481","journal-title":"Age Ageing"},{"key":"983_CR17","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afac005","author":"P Sommerville","year":"2022","unstructured":"Sommerville P, Hayton J, Soar N, Archer S, Fitzgerald A, Lang A et al (2022) Prognosis in dysphagic patients who are eating and drinking with acknowledged risk: results from the evaluation of the FORWARD project. Age Ageing. https:\/\/doi.org\/10.1093\/ageing\/afac005","journal-title":"Age Ageing."},{"key":"983_CR18","volume-title":"Principles of biomedical ethics","author":"T Beauchamp","year":"2012","unstructured":"Beauchamp T, Childress J (2012) Principles of biomedical ethics, 7th edn. Oxford University Press, Inc, Oxford","edition":"7"}],"container-title":["European Geriatric Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41999-024-00983-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s41999-024-00983-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41999-024-00983-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T06:28:52Z","timestamp":1723789732000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s41999-024-00983-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,9]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["983"],"URL":"https:\/\/doi.org\/10.1007\/s41999-024-00983-2","relation":{},"ISSN":["1878-7657"],"issn-type":[{"value":"1878-7657","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,9]]},"assertion":[{"value":"15 February 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The corresponding author is supported by The Japanese Respiratory Society Fellowship Grant. This study was funded by the Great Britain Sasakawa Foundation (Butterfield Award). The sponsors had no role in this study design, review process, writing of the manuscript, or decision to publish. The authors received no other financial support for the research, authorship and publication of this article. The authors declare that they have no other competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval was obtained from the Lewisham and Greenwich NHS Trust (Number 7211).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was waived due to the retrospective nature of the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}