A multicentre evaluation of oropharyngeal secretion management practices in amyotrophic lateral sclerosis.

2.50
Hdl Handle:
http://hdl.handle.net/11287/619937
Title:
A multicentre evaluation of oropharyngeal secretion management practices in amyotrophic lateral sclerosis.
Authors:
McGeachan, A J; Hobson, E V; Al-Chalabi, A; Stephenson, J; Chandran, S; Crawley, F; Dick, D; Donaghy, C; Ellis, C M; Gorrie, G; Hanemann, O C; Harrower, Timothy; Jung, A; Malaspina, A; Morrison, K E; Orrell, R W; Talbot, K; Turner, M R; Williams, T L; Young, C A; Shaw, P J; McDermott, C J
Abstract:
Failure to clear oral secretions can be debilitating for patients with amyotrophic lateral sclerosis (ALS), but the treatment of this symptom is poorly defined and there is no consensus on best practice. The objective of this study was to identify the treatments that are commonly prescribed, and to describe how experienced clinicians manage a patient with treatment resistant symptoms. Twenty-three clinicians were approached, of which 19 from 16 centres across the UK provided case report forms for a total of 119 ALS patients identified as having problematic oral secretions. The use of five anticholinergics, salivary gland botulinum toxin injections, conservative management approaches and carbocisteine were reported. Of the 72 patients who were evaluated following the initiation of a first anticholinergic, 61% had symptomatic improvement. Only 19% of patients achieved symptomatic improvement with the use of an alternative anticholinergic when an initial anticholinergic achieved no symptomatic improvement. Problems with thick and thin secretions often coexisted, with 37% of patients receiving treatment for both types of problem. In conclusion, a variety of treatment options are employed by expert clinicians for problematic oral secretions in ALS patients. The variation in management highlights the need for further prospective research in this area.
Citation:
A multicentre evaluation of oropharyngeal secretion management practices in amyotrophic lateral sclerosis. 2017 Feb;18(1-2):1-9 Amyotroph Lateral Scler Frontotemporal Degener
Publisher:
Taylor & Francis
Journal:
Amyotrophic lateral sclerosis & frontotemporal degeneration
Issue Date:
31-Aug-2016
URI:
http://hdl.handle.net/11287/619937
DOI:
10.1080/21678421.2016.1221433
PubMed ID:
27579520
Additional Links:
http://www.tandfonline.com/doi/full/10.1080/21678421.2016.1221433
Type:
Journal Article; Evaluation Studies
Language:
en
ISSN:
2167-9223
Appears in Collections:
Neurology; 2016 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorMcGeachan, A Jen
dc.contributor.authorHobson, E Ven
dc.contributor.authorAl-Chalabi, Aen
dc.contributor.authorStephenson, Jen
dc.contributor.authorChandran, Sen
dc.contributor.authorCrawley, Fen
dc.contributor.authorDick, Den
dc.contributor.authorDonaghy, Cen
dc.contributor.authorEllis, C Men
dc.contributor.authorGorrie, Gen
dc.contributor.authorHanemann, O Cen
dc.contributor.authorHarrower, Timothyen
dc.contributor.authorJung, Aen
dc.contributor.authorMalaspina, Aen
dc.contributor.authorMorrison, K Een
dc.contributor.authorOrrell, R Wen
dc.contributor.authorTalbot, Ken
dc.contributor.authorTurner, M Ren
dc.contributor.authorWilliams, T Len
dc.contributor.authorYoung, C Aen
dc.contributor.authorShaw, P Jen
dc.contributor.authorMcDermott, C Jen
dc.date.accessioned2016-09-07T09:16:09Z-
dc.date.available2016-09-07T09:16:09Z-
dc.date.issued2016-08-31-
dc.identifier.citationA multicentre evaluation of oropharyngeal secretion management practices in amyotrophic lateral sclerosis. 2017 Feb;18(1-2):1-9 Amyotroph Lateral Scler Frontotemporal Degeneren
dc.identifier.issn2167-9223-
dc.identifier.pmid27579520-
dc.identifier.doi10.1080/21678421.2016.1221433-
dc.identifier.urihttp://hdl.handle.net/11287/619937-
dc.description.abstractFailure to clear oral secretions can be debilitating for patients with amyotrophic lateral sclerosis (ALS), but the treatment of this symptom is poorly defined and there is no consensus on best practice. The objective of this study was to identify the treatments that are commonly prescribed, and to describe how experienced clinicians manage a patient with treatment resistant symptoms. Twenty-three clinicians were approached, of which 19 from 16 centres across the UK provided case report forms for a total of 119 ALS patients identified as having problematic oral secretions. The use of five anticholinergics, salivary gland botulinum toxin injections, conservative management approaches and carbocisteine were reported. Of the 72 patients who were evaluated following the initiation of a first anticholinergic, 61% had symptomatic improvement. Only 19% of patients achieved symptomatic improvement with the use of an alternative anticholinergic when an initial anticholinergic achieved no symptomatic improvement. Problems with thick and thin secretions often coexisted, with 37% of patients receiving treatment for both types of problem. In conclusion, a variety of treatment options are employed by expert clinicians for problematic oral secretions in ALS patients. The variation in management highlights the need for further prospective research in this area.en
dc.languageENG-
dc.language.isoenen
dc.publisherTaylor & Francisen
dc.relation.urlhttp://www.tandfonline.com/doi/full/10.1080/21678421.2016.1221433en
dc.rightsArchived with thanks to Amyotrophic lateral sclerosis & frontotemporal degenerationen
dc.subjectWessex Classification Subject Headings::Neurologyen
dc.titleA multicentre evaluation of oropharyngeal secretion management practices in amyotrophic lateral sclerosis.en
dc.typeJournal Articleen
dc.typeEvaluation Studiesen
dc.identifier.journalAmyotrophic lateral sclerosis & frontotemporal degenerationen
dc.type.versionPublisheden

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