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BTS Clinical Statement
BTS Clinical Statement on the prevention and management of community-acquired pneumonia in people with learning disability
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  1. Julian Legg1,2,
  2. Jamie-Leigh Allen3,
  3. Morag Andrew4,5,
  4. Charlotte Annesley6,
  5. Michelle Chatwin7,
  6. Hannah Crawford8,
  7. Joanna Elverson5,9,
  8. Julian Forton10,
  9. Kate Oulton11,
  10. Kate Renton12,13,
  11. Alison Tavare14,15,
  12. Hilary Tedd5,
  13. A John Simpson4,5
  1. 1Department of Paediatric Respiratory Medicine, Southampton Children's Hospital, Southampton, UK
  2. 2NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Trust & University of Southampton, Southamptom, UK
  3. 3Speech and Language Therapy, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  4. 4Newcastle University, Newcastle upon Tyne, UK
  5. 5Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  6. 6North Middlesex University Hospital NHS Trust, London, UK
  7. 7Academic and Clinical Department of Sleep and Breathing, Royal Brompton Hospital, London, UK
  8. 8Tees Esk and Wear Valleys NHS Foundation Trust, Darlington, UK
  9. 9St Oswalds’ Hospice, Newcastle upon Tyne, UK
  10. 10Cardiff University, Cardiff, UK
  11. 11Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  12. 12Paediatric Palliative Care, Southampton Children's Hospital, Southampton, UK
  13. 13Naomi House and Jacksplace, Winchester, UK
  14. 14West of England Academic Health Science Network, Bristol, UK
  15. 15South West Learning Disability and Autism Team, NHS England, Bristol, UK
  1. Correspondence to Dr Julian Legg; Julian.Legg{at}uhs.nhs.uk

https://doi.org/10.1136/thorax-2022-219698

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    Introduction

    This BTS Clinical Statement addresses the risk assessment, prevention and management of community-acquired pneumonia (CAP) in people with a learning disability of all ages. Each section is summarised with key clinical practice points. The recommendations made are based on a comprehensive review of the published evidence, where available and pertinent, but are predominantly based on expert opinion aimed at providing useful pragmatic guidance.

    Learning disability is the preferred term used in the UK to refer to individuals who have ‘significantly reduced ability to understand new or complex information, to learn new skills’ and a ‘reduced ability to cope independently which starts before adulthood with lasting effects on development’.1 Individuals with learning disability represent a widely heterogeneous group of people and can be associated with a broad range of primary diagnoses and comorbidities.2

    There is no definitive record of the number of people with learning disability in England. However, Public Health England (PHE) estimates that in 2015 the population was 1 087 100, including 930 400 adults (approximating 2% of the adult population). The estimated prevalence of learning disability in children and young people (CYP) is 2.5%.3 Far fewer individuals with learning disability were recorded in health and welfare systems. For example, only 324 291 children and adults were identified as having learning disability on general practitioner (GP) practice-based registers in 2021.4 It is likely that those registered have a more severe learning disability or more commonly associated conditions, for example, Down syndrome. This is important, as it means that many individuals with learning disability do not have their diagnosis recognised within health and welfare systems potentially increasing their vulnerability through lack of access to regular health reviews and other relevant public health programmes, for example, vaccination programmes. A series of measures have been introduced by the National Health …

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