TY - JOUR
T1 - Non-invasive ventilation support for people with Amyotrophic Lateral Sclerosis: Multidisciplinary team management
AU - Barry, Caroline
AU - Larner, Emma
AU - Copsey, Helen
AU - Smith, Matthew
AU - Peryer, Guy
PY - 2021/12
Y1 - 2021/12
N2 - PURPOSE OF REVIEW: To summarise recent developments in the use of noninvasive ventilation (NIV) for people with amyotrophic lateral sclerosis (pwALS), with a specific focus on how multidisciplinary teams (MDT) can support best practice. RECENT FINDINGS: We included 13 papers, 12 with observational designs and one qualitative interview design. The review is structured using four content domains: prognosis, the effectiveness of NIV, NIV tolerance, and MDT structure and delivery. Findings suggest a modest survival benefit of NIV for pwALS. Further evidence is needed to consider the appropriate time of initiation in the context of respiratory status and the influence of NIV on cognitive function over the course of the disease. A key emerging determinant of tolerability of NIV is secretion load. Palliative care professionals within the MDT can play a key role in supporting pwALS to consider the potential benefits of NIV in the context of their preferences, prognosis, symptom burden, and ALS variant. SUMMARY: ALS MDTs allow timely information sharing about NIV between experts that is likely to improve outcomes. MDT practice must continually adapt to reflect pwALS's preferences for care and ensure those caring for them at home have access to support using digital innovations.
AB - PURPOSE OF REVIEW: To summarise recent developments in the use of noninvasive ventilation (NIV) for people with amyotrophic lateral sclerosis (pwALS), with a specific focus on how multidisciplinary teams (MDT) can support best practice. RECENT FINDINGS: We included 13 papers, 12 with observational designs and one qualitative interview design. The review is structured using four content domains: prognosis, the effectiveness of NIV, NIV tolerance, and MDT structure and delivery. Findings suggest a modest survival benefit of NIV for pwALS. Further evidence is needed to consider the appropriate time of initiation in the context of respiratory status and the influence of NIV on cognitive function over the course of the disease. A key emerging determinant of tolerability of NIV is secretion load. Palliative care professionals within the MDT can play a key role in supporting pwALS to consider the potential benefits of NIV in the context of their preferences, prognosis, symptom burden, and ALS variant. SUMMARY: ALS MDTs allow timely information sharing about NIV between experts that is likely to improve outcomes. MDT practice must continually adapt to reflect pwALS's preferences for care and ensure those caring for them at home have access to support using digital innovations.
KW - Amyotrophic Lateral Sclerosis
KW - Non-invasive ventilation
KW - Multidisciplinary team
UR - http://www.scopus.com/inward/record.url?scp=85121957638&partnerID=8YFLogxK
U2 - 10.1097/SPC.0000000000000570
DO - 10.1097/SPC.0000000000000570
M3 - Article
VL - 15
SP - 214
EP - 218
JO - Current Opinion in Supportive and Palliative Care
JF - Current Opinion in Supportive and Palliative Care
SN - 1751-4258
IS - 4
ER -