期刊
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
卷 86, 期 5, 页码 496-501出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/jnnp-2014-309601
关键词
-
资金
- Health Research Board Interdisciplinary Capacity Enhancement Programme
- European Community [259867]
- European Joint Programme in Neurodegeneration (SOPHIA)
- European Joint Programme in Neurodegeneration (ALS-CarE)
- Charities Research Motor Neurone
- Irish Motor Neurone Disease Association
Background Amyotrophic lateral sclerosis ( ALS) is a progressive debilitating neurodegenerative disease, with a life expectancy of 3-5 years from first symptom. There is compelling evidence that those who attend a multidisciplinary clinic experience improved survival. The purpose of the study was to explore the survival of patients with ALS ascertained through population-based Registers in the Republic of Ireland ( RoI) and Northern Ireland ( NI), and to determine whether centralisation of services confers advantage compared with community-based care supported by a specialist care worker. Methods The island of Ireland is divided into two countries, RoI and NI, each with an independent healthcare system. Both countries have population-based ALS Registers with full ascertainment. Data from all 719 incident ALS cases from Ireland and NI, diagnosed between 1 January 2005 and 31 December 2010, were used in the analysis. Results A survival benefit was identified for patients who attended the multidisciplinary ALS clinic in the RoI. (HR 0.59, 95% CI 0.49 to 0.71, p<0.001). This difference was preserved following multivariate analysis. A trend towards improved survival was noted for patients with ALS from NI when compared with RoI patients who did not attend a multidisciplinary clinic. Conclusions Centralised multidisciplinary care confers a survival advantage for patients with ALS and is superior to devolved community-based care. We propose that multiple decision-making processes within a multidisciplinary setting lead to an enriched set of clinical encounters for the patient and carer that enhances clinical outcome.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据