If the agreed views of these experienced doctors and nurses are correct, provision of additional services in the community could be an important means of preventing emergency admissions for respiratory disease. This hypothesis should be tested by further research including the views of families. The study provides further evidence that the modified PAEP may not be valid for use in UK practice. If inappropriate admission rates are to be used to measure effectiveness of services we need to develop an objective measure of appropriateness valid for use in the UK.
A629ment was associated with 38% fewer unplanned admissions (981 vs. 604, X 1 2 = 89.2, p< 0.001) and 58% fewer unplanned bed nights (8,817 vs. 3,681, X 1 2 = 2109.8, p< 0.001) in the year following treatment initiation compared with the year before. A 14% reduction in all outpatient appointments was also observed, due principally to a 25% reduction in neurological outpatient appointments (from 7,826 to 5,901, X 1 2 = 269.7, p< 0.001). Evidence from this study indicates that duration of treatment is a significant factor in this response; patients receiving between 12 and 14 doses (n= 1,122) experienced 70% reduction in unplanned admissions and 90% reduction in unplanned bed nights. ConClusions: Our data support the notion that natalizumab treatment significantly reduces unplanned hospital treatment and outpatient attendance.
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