Prevalence of multimorbidity and its impact on survival in people with motor neuron disease

Glasmacher, Stella A.; Kearns, Patrick K. A.; Larraz, Juan; Stirland, Lucy; Mehta, Arpan R.; Newton, Judith; Weir, Christopher; Chandran, Siddharthan; Pal, Suvankar; Davenport, Richard; Thomson, David; Murrie, Louise; Preston, Jennifer; Chavada, Govind; Swingler, Robert; Leighton, Danielle; Morrison, Ian; Gorrie, George; Duncan, Callum W.; Connor, Myles; Simpson, David; Doležal, Ondřej; Lassak, Katja; Benvenga, Antonella; Artal, Javier Carod; Bethell, Andrew; Craig, Gillian; Cunningham, Laura; Flett, Moira; Hatrick, Janice; Lennox, Helen; Marshall, Laura; McEleney, Alison; Millar, Kitty; Stewart, Susan D.; Storey, Dorothy; Saravanan, Gowri; Stott, Gill; Webber, Carolyn

doi:10.1111/ene.14940

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…Only one case-control study 28 31 With exceptionally high rates of case ascertainment (>95%) and extensive clinical phenotyping, the register has enabled researchers to investigate several important questions about MND. 32 Of particular note, Leighton et al 30 reported analysis from the Scottish National MND register, finding that the standardised incidence in Scotland was 67% higher even than the Northern European estimates in 2015-2016. 30 MND specialist nurses are ideally placed working in localised areas.…”

Section: Introductionmentioning

confidence: 99%

Motor Neuron Disease is not clustered or associated with socioeconomic deprivation in Scotland

Chang

Kearns

Newton

et al. 2022

Preprint

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Background and Objectives: Understanding risk factors and spatial variation of risk may provide insights into the pathological mechanism of motor neuron disease (MND). Socioeconomic status (SES) has been hypothesised as a risk factor, but results from previous studies are inconsistent. No spatial epidemiology studies examining geographic clustering of MND have been performed in Scotland to date. We investigated the effect of SES and geography on MND risk in Scotland using the highly curated and nationally representative Scottish MND Register (CARE-MND) that has over 95% case ascertainment. Methods: Patients on the Scottish Clinical Audit Research Evaluation for Motor Neurone Disease platform, with date of diagnosis between 01 Jan 2015 and 28 Feb 2021 were included and geocoded with data zones using their residence at diagnosis. Indirectly standardised incidence ratio (SIR) accounting for age and sex was calculated for each health board. Poisson regression was used to examine the effect of SES on MND risk, adjusted for age and sex of population at risk. Geographic clustering was assessed using global Moran's Index, Bayesian conditional autoregressive models and SaTScan software. Results: Among 1149 patients included, 1126 (98%) were successfully geocoded. Significantly lower SIR was shown in Highland (0.60, 95% CI 0.44-0.80, p<0.001). After adjusting for age and sex in Poisson regression, there was no significant effect of SES on MND risk. Moran's Index indicated a weak but significant spatial autocorrelation (I=0.017, p=0.008). However, risk maps using Bayesian modelling showed a relatively homogeneous distribution without distinct patterns across Scotland. Similarly, SaTScan did not detect any significant cluster of high or low risks. Discussion: Our findings support the notion that MND risk is mostly random-distributed and independent of SES in Scotland. Our results are generalizable to other MND populations.

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Section: Introductionmentioning

confidence: 99%

Motor Neuron Disease is not clustered or associated with socioeconomic deprivation in Scotland

Chang

Kearns

Newton

et al. 2022

Preprint

Self Cite

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Impact of multimorbidity patterns in hospital admissions: the case study of asthma

et al. 2023

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Influences of Specialist Palliative Care Team Input, Advance Care Planning, Non-Invasive Ventilation and Gastrostomy Status on Unscheduled Hospital Admissions and Place of Death for People with Motor Neuron Disease: A Retrospective Cohort Analysis

Quail,

Leighton,

Newton

et al. 2024

J Palliat Care

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Objective Motor neuron disease is a rapidly progressing neurological condition. People with life-limiting conditions generally prefer to die at home and avoid hospital admissions, with Specialist Palliative Care Team involvement often pivotal. Our aim was to investigate the role of advance care planning, Specialist Palliative Care Team input and other relevant variables on place of death and unscheduled hospital admissions in a Scottish population of people with motor neuron disease. Methods: National CARE-MND audit data, primary and secondary care data, and local Palliative Care records were interrogated. Chi-square, point-biserial correlation and binary logistic regression analysed associations (p < 0.05 statistically significant). Participants (188) were deceased, having a verified motor neuron disease diagnosis between 2015–2017, diagnosis occurring ≥28 days before death. Results: Advance care planning and Specialist Palliative Care Team input of ≥28 days were associated with increased odds of dying outside hospital (BLR:OR 3.937, CI 1.558-9.948, p = 0.004 and OR 2.657, CI 1.135-6.222, p = 0.024 respectively). Non-invasive ventilation decreased the odds of dying outside hospital (BLR:OR 0.311, CI 0.124-0.781, p = 0.013). Having a gastrostomy increased odds of ≥1 admissions in the last year of life (BLR:OR 5.142, CI 1.715-15.417, p = 0.003). Statistical significance was retained with removal of gastrostomy-related complications. Conclusion: Early Specialist Palliative Care input and advance care planning may increase the likelihood of death outside of hospital for persons with motor neuron disease. Further research is warranted into barriers of facilitating death outside of hospital with home non-invasive ventilation use and the association between gastrostomy status and unscheduled admissions.

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Prevalence of multimorbidity and its impact on survival in people with motor neuron disease

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 3 publications

References 38 publications

Motor Neuron Disease is not clustered or associated with socioeconomic deprivation in Scotland

Motor Neuron Disease is not clustered or associated with socioeconomic deprivation in Scotland

Impact of multimorbidity patterns in hospital admissions: the case study of asthma

Influences of Specialist Palliative Care Team Input, Advance Care Planning, Non-Invasive Ventilation and Gastrostomy Status on Unscheduled Hospital Admissions and Place of Death for People with Motor Neuron Disease: A Retrospective Cohort Analysis

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