Contributions of pharmaceutical interventions to the multidisciplinary dysphagia team: A retrospective observational study
Abstract Background The 2022 revision of Japanese healthcare reimbursement removed pharmacists from the mandatory dysphagia team, despite emerging evidence of medication-related swallowing complications. Our previous pharmacovigilance analysis identified dopamine-blocking drugs as primary contributo...
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BMC
2025-08-01
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| Series: | Journal of Pharmaceutical Health Care and Sciences |
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| Online Access: | https://doi.org/10.1186/s40780-025-00474-x |
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| author | Akihito Ueda Michiko Obara Shinichi Watanabe |
| author_facet | Akihito Ueda Michiko Obara Shinichi Watanabe |
| author_sort | Akihito Ueda |
| collection | DOAJ |
| description | Abstract Background The 2022 revision of Japanese healthcare reimbursement removed pharmacists from the mandatory dysphagia team, despite emerging evidence of medication-related swallowing complications. Our previous pharmacovigilance analysis identified dopamine-blocking drugs as primary contributors to the risk of aspiration pneumonia. This study aimed to validate these findings through a clinical examination of pharmaceutical interventions performed by a multidisciplinary dysphagia team. Methods This retrospective observational study was conducted at a 97-bed community hospital in Osaka, Japan, from June 2023 to January 2024. All adult patients with suspected dysphagia who underwent a multidisciplinary team intervention were included in our analysis. Pharmaceutical intervention was requested when medication-related dysphagia or swallowing difficulties were suspected, with interventions classified into the following four categories: drug-induced dysphagia management, dosage form optimization, swallowing aid utilization, and medication burden reduction. Changes in the medication burden were analyzed using paired t-tests. Results Among 59 patients with dysphagia (mean age, 81.1 ± 9.8 years; 33 males [55.9%], 26 females [44.1%]), 13 (22.0%) underwent pharmaceutical interventions. Drug-induced dysphagia management was the most common intervention (69.2%), targeting dopamine antagonists (sulpiride, risperidone, tiapride, and domperidone), benzodiazepines, and anticholinergics without dopamine-blocking effects. Suspected drug-induced dysphagia was the most common symptom among patients with dementia (38.9%). The intervention group showed a significant reduction in medication (mean, -3.2 medications; P < 0.001), whereas the non-intervention group showed no change. Among the non-intervention group, potential opportunities for the optimization of angiotensin-converting enzyme inhibitors were identified in antihypertensive therapy. Conclusions Pharmaceutical interventions may offer clinically meaningful contributions when utilized for patients with dysphagia, supporting the relevance of pharmacovigilance regarding the risks of dopamine antagonists. The findings of this study suggest the importance of reinstating pharmaceutical expertise to multidisciplinary dysphagia teams, as pharmacists provide clinically significant medication optimization, including identifying additional optimization opportunities through systematic medication reviews among vulnerable populations. |
| format | Article |
| id | doaj-art-1e67643bddfe4723a7d57e9dab25352e |
| institution | Kabale University |
| issn | 2055-0294 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Pharmaceutical Health Care and Sciences |
| spelling | doaj-art-1e67643bddfe4723a7d57e9dab25352e2025-08-20T03:43:29ZengBMCJournal of Pharmaceutical Health Care and Sciences2055-02942025-08-011111710.1186/s40780-025-00474-xContributions of pharmaceutical interventions to the multidisciplinary dysphagia team: A retrospective observational studyAkihito Ueda0Michiko Obara1Shinichi Watanabe2Doctoral Program in Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Teikyo Heisei UniversityFaculty of Pharmaceutical Sciences, Teikyo Heisei UniversityFaculty of Pharmaceutical Sciences, Teikyo Heisei UniversityAbstract Background The 2022 revision of Japanese healthcare reimbursement removed pharmacists from the mandatory dysphagia team, despite emerging evidence of medication-related swallowing complications. Our previous pharmacovigilance analysis identified dopamine-blocking drugs as primary contributors to the risk of aspiration pneumonia. This study aimed to validate these findings through a clinical examination of pharmaceutical interventions performed by a multidisciplinary dysphagia team. Methods This retrospective observational study was conducted at a 97-bed community hospital in Osaka, Japan, from June 2023 to January 2024. All adult patients with suspected dysphagia who underwent a multidisciplinary team intervention were included in our analysis. Pharmaceutical intervention was requested when medication-related dysphagia or swallowing difficulties were suspected, with interventions classified into the following four categories: drug-induced dysphagia management, dosage form optimization, swallowing aid utilization, and medication burden reduction. Changes in the medication burden were analyzed using paired t-tests. Results Among 59 patients with dysphagia (mean age, 81.1 ± 9.8 years; 33 males [55.9%], 26 females [44.1%]), 13 (22.0%) underwent pharmaceutical interventions. Drug-induced dysphagia management was the most common intervention (69.2%), targeting dopamine antagonists (sulpiride, risperidone, tiapride, and domperidone), benzodiazepines, and anticholinergics without dopamine-blocking effects. Suspected drug-induced dysphagia was the most common symptom among patients with dementia (38.9%). The intervention group showed a significant reduction in medication (mean, -3.2 medications; P < 0.001), whereas the non-intervention group showed no change. Among the non-intervention group, potential opportunities for the optimization of angiotensin-converting enzyme inhibitors were identified in antihypertensive therapy. Conclusions Pharmaceutical interventions may offer clinically meaningful contributions when utilized for patients with dysphagia, supporting the relevance of pharmacovigilance regarding the risks of dopamine antagonists. The findings of this study suggest the importance of reinstating pharmaceutical expertise to multidisciplinary dysphagia teams, as pharmacists provide clinically significant medication optimization, including identifying additional optimization opportunities through systematic medication reviews among vulnerable populations. https://doi.org/10.1186/s40780-025-00474-xDysphagiaDrug-induced dysphagiaPharmaceutical interventionMultidisciplinary teamDopamine antagonistPolypharmacy |
| spellingShingle | Akihito Ueda Michiko Obara Shinichi Watanabe Contributions of pharmaceutical interventions to the multidisciplinary dysphagia team: A retrospective observational study Journal of Pharmaceutical Health Care and Sciences Dysphagia Drug-induced dysphagia Pharmaceutical intervention Multidisciplinary team Dopamine antagonist Polypharmacy |
| title | Contributions of pharmaceutical interventions to the multidisciplinary dysphagia team: A retrospective observational study |
| title_full | Contributions of pharmaceutical interventions to the multidisciplinary dysphagia team: A retrospective observational study |
| title_fullStr | Contributions of pharmaceutical interventions to the multidisciplinary dysphagia team: A retrospective observational study |
| title_full_unstemmed | Contributions of pharmaceutical interventions to the multidisciplinary dysphagia team: A retrospective observational study |
| title_short | Contributions of pharmaceutical interventions to the multidisciplinary dysphagia team: A retrospective observational study |
| title_sort | contributions of pharmaceutical interventions to the multidisciplinary dysphagia team a retrospective observational study |
| topic | Dysphagia Drug-induced dysphagia Pharmaceutical intervention Multidisciplinary team Dopamine antagonist Polypharmacy |
| url | https://doi.org/10.1186/s40780-025-00474-x |
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