Consensus expert recommendations for management of dysphagia during hospital admission in Parkinson's disease

Dysphagia is a common and often underrecognized symptom in patients with Parkinson's disease (PD) that is frequently overlooked during hospitalization. Dysphagia may be present without overt clinical signs, complicating timely identification and intervention. The absence of clear guidelines for managing dysphagia in hospitalized patients with PD often results in delays in medication administration, with subsequent deterioration in both motor and non-motor symptoms. This consensus paper, developed through collaboration among experts in otolaryngology, gastroenterology, neurology, hospital medicine, nursing, social work, speech-language pathology, pharmacy, and nutrition, presents comprehensive recommendations for the evaluation and management of dysphagia in hospitalized patients with PD. These guidelines emphasize the importance of early screening, appropriate diagnostic evaluation, and multidisciplinary involvement to support timely and safe oral intake and sustained medication schedules. Special consideration is given to the role of alternative medication formulations and compensatory strategies when swallowing impairments are identified. Recognizing the variability in access to specialty care, especially in rural and community hospital settings, these recommendations also provide practical tools for providers. They outline when to initiate swallowing evaluations, criteria for specialist referral, use of telemedicine for consultations with specialists, and strategies to bridge care from the inpatient to outpatient setting. By implementing these consensus guidelines, healthcare teams can improve the safety, outcomes, and hospital experience of patients with PD, while reducing complications and length of stay associated with dysphagia-related issues.