179 Improving respiratory screening and NIV assessment in motor neuron disease

Abstract

Motor neurone disease (MND) commonly causes death from respiratory muscle weakness. Non-invasive ventilation (NIV) is currently the most life-prolonging treatment, and its inclusion in NICE guidelines has increased respiratory function testing, respiratory referrals and usage. Earlier referral to respiratory services results in more hospital appointments before NIV initiation. We aimed to assess whether patients were receiving NICE-compliant respiratory screening and calculate the NIV uptake rate of those referred. We also sought to measure the effect of NIV on survival. We retrospectively examined 194 patient records from the SRFT MND care centre between 1st January and 31st December 2016. A Kaplan-Meier analysis was used to calculate survival. All appropriate patients received NICE-compliant respiratory screening, with 27% patients referred for NIV. Of those referred 33% were started on NIV at initial assessment, and 12% during follow up. Non-invasive ventilation increased survival by 265 days. The result of NICE-compli- ant practice is a low rate of NIV uptake, burdening patients and services with extra appointments. NIV significantly increases life expectancy and patients must receive it as soon as it is indicated. We plan to incorporate NIV assessment by respiratory physicians within the MND clinic to complement the screening process and reduce unnecessary referrals.daniel.rice-wilson@nhs.net