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Management of sialorrhoea in motor neuron disease: a survey of current UK practice

Management of sialorrhoea in motor neuron disease: a survey of current UK practice
Management of sialorrhoea in motor neuron disease: a survey of current UK practice
Our objective was to better understand UK-wide practice in managing sialorrhoea in motor neuron disease among specialist clinicians. We used a survey of neurologists in the UK with a special interest in motor neuron disease designed to establish clinicians' attitudes towards treatment options and resources for sialorrhoea management. Twenty-three clinicians replied, representing 21 centres. Sixteen centres were specialist MND Care Centres. Clinicians estimated seeing a total of 1391 newly diagnosed patients with MND in 2011. One hundred and ninety-three patients were described. Forty-two percent of patients reviewed in clinicians' last clinic had sialorrhoea and 46% of those with sialorrhoea had uncontrolled symptoms. Clinicians' preferred drugs were hyoscine patches, amitriptyline, carbocisteine and botulinum toxin. Botulinum toxin was used in 14 centres. Risk of dysphagia and staff skills were identified as the main barriers to botulinum toxin use. This survey suggests that there may be as many as 1700 patients with MND in the UK who have symptoms of sialorrhoea and that symptoms may be poorly controlled in nearly half. Treatment strategies varied, reflecting the lack of evidence based guidelines. The use of specialist treatments was influenced by local infrastructure. This study highlights the need for further work to develop evidence based guidance.
2167-8421
521-527
Hobson, Esther V.
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McGeachan, Alexander
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Al-Chalabi, Ammar
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Chandran, Siddharthan
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Crawley, Francesca
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Dick, David
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Donaghy, Colette
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Ealing, John
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Ellis, Cathy M.
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Gorrie, George
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Hanemann, C. Oliver
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Harrower, Timothy
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Jung, Agam
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Majeed, Tahir
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Malaspina, Andrea
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Morrison, Karen
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Orrell, Richard W.
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Pall, Hardev
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Pinto, Ashwin
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Talbot, Kevin
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Turner, Martin R.
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Williams, Timothy L.
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Young, Carolyn A.
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Shaw, Pamela J.
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McDermott, Christopher J.
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Hobson, Esther V.
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McGeachan, Alexander
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Al-Chalabi, Ammar
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Chandran, Siddharthan
639bc33c-60c1-489b-8ea7-f7a156dfb295
Crawley, Francesca
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Dick, David
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Donaghy, Colette
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Ealing, John
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Ellis, Cathy M.
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Gorrie, George
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Hanemann, C. Oliver
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Harrower, Timothy
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Jung, Agam
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Majeed, Tahir
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Malaspina, Andrea
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Morrison, Karen
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Orrell, Richard W.
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Pall, Hardev
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Pinto, Ashwin
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Talbot, Kevin
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Turner, Martin R.
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Williams, Timothy L.
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Young, Carolyn A.
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Shaw, Pamela J.
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McDermott, Christopher J.
107ae1fb-878d-4197-a620-ee4fbb66f41d

Hobson, Esther V., McGeachan, Alexander, Al-Chalabi, Ammar, Chandran, Siddharthan, Crawley, Francesca, Dick, David, Donaghy, Colette, Ealing, John, Ellis, Cathy M., Gorrie, George, Hanemann, C. Oliver, Harrower, Timothy, Jung, Agam, Majeed, Tahir, Malaspina, Andrea, Morrison, Karen, Orrell, Richard W., Pall, Hardev, Pinto, Ashwin, Talbot, Kevin, Turner, Martin R., Williams, Timothy L., Young, Carolyn A., Shaw, Pamela J. and McDermott, Christopher J. (2013) Management of sialorrhoea in motor neuron disease: a survey of current UK practice. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 14 (7-8), 521-527. (doi:10.3109/21678421.2013.790452). (PMID:23647474)

Record type: Article

Abstract

Our objective was to better understand UK-wide practice in managing sialorrhoea in motor neuron disease among specialist clinicians. We used a survey of neurologists in the UK with a special interest in motor neuron disease designed to establish clinicians' attitudes towards treatment options and resources for sialorrhoea management. Twenty-three clinicians replied, representing 21 centres. Sixteen centres were specialist MND Care Centres. Clinicians estimated seeing a total of 1391 newly diagnosed patients with MND in 2011. One hundred and ninety-three patients were described. Forty-two percent of patients reviewed in clinicians' last clinic had sialorrhoea and 46% of those with sialorrhoea had uncontrolled symptoms. Clinicians' preferred drugs were hyoscine patches, amitriptyline, carbocisteine and botulinum toxin. Botulinum toxin was used in 14 centres. Risk of dysphagia and staff skills were identified as the main barriers to botulinum toxin use. This survey suggests that there may be as many as 1700 patients with MND in the UK who have symptoms of sialorrhoea and that symptoms may be poorly controlled in nearly half. Treatment strategies varied, reflecting the lack of evidence based guidelines. The use of specialist treatments was influenced by local infrastructure. This study highlights the need for further work to develop evidence based guidance.

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More information

Accepted/In Press date: 3 March 2013
e-pub ahead of print date: 7 May 2013
Published date: December 2013
Organisations: Medical Education

Identifiers

Local EPrints ID: 398339
URI: http://eprints.soton.ac.uk/id/eprint/398339
ISSN: 2167-8421
PURE UUID: 9754c054-8f35-4933-8dc0-7568c5f1745b
ORCID for Karen Morrison: ORCID iD orcid.org/0000-0003-0216-5717

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Date deposited: 21 Jul 2016 14:26
Last modified: 20 Jul 2019 00:33

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Contributors

Author: Esther V. Hobson
Author: Alexander McGeachan
Author: Ammar Al-Chalabi
Author: Siddharthan Chandran
Author: Francesca Crawley
Author: David Dick
Author: Colette Donaghy
Author: John Ealing
Author: Cathy M. Ellis
Author: George Gorrie
Author: C. Oliver Hanemann
Author: Timothy Harrower
Author: Agam Jung
Author: Tahir Majeed
Author: Andrea Malaspina
Author: Karen Morrison ORCID iD
Author: Richard W. Orrell
Author: Hardev Pall
Author: Ashwin Pinto
Author: Kevin Talbot
Author: Martin R. Turner
Author: Timothy L. Williams
Author: Carolyn A. Young
Author: Pamela J. Shaw
Author: Christopher J. McDermott

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