BackgroundUnwarranted variation in treatment, care and support for people with dementia is well documented. To improve equity of service, in line with the NHS Long Term Plan, it is imperative that we understand how sociodemographic factors affect management and care of dementia.AimTo review published literature between sociodemographic factors and clinical factors, diagnosis, treatment and outcomes for people with dementia.MethodWe conducted a focused review of published literature between 2000-2021 to outline the evidence describing the relationship between the ten protected characteristics of the Equality Act 2010 and clinical factors, treatment and outcomes in dementia. Other factors such as deprivation, settlement status, education and employment were also explored.ResultsThere is an abundance of published literature on age, race, geographical variation, sex and gender. Evidence is lacking for relationship between disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, religion and belief, sexual orientation, immigration and settlement.DiscussionBetter understanding of sociodemographic factors of our patient group is key to improving equity of care. This review has identified gaps in knowledge on factors that may affect how patients access care to dementia services.
BackgroundTo improve equity of service provided to people with Multiple Sclerosis (MS), in line with the aspirations of public policy across the UK, it is imperative to understand how sociodemographic factors affect management and care of people with MS.MethodsWe conducted a focused review of literature published between 2000-2021 to outline the evidence describing the relationship between the nine protected characteristics of the Equality Act 2010 and the epidemiology, diagnosis, management, and outcomes of MS. Other factors such as deprivation, settlement status, education and employment were also explored.ResultsThere is much published literature on the relationship between age, sex, geographical factors, pregnancy and MS epidemiology and management. There is also good quality evidence regarding the large disability burden caused globally. Further research is required to explore racial differences in disease onset, progression, and disability as well as the relationship between MS care and religious factors, sexual orientation, gender reassignment and socioeconomic factors, particularly in UK settings.DiscussionBetter understanding of sociodemographic factors and their relationship with MS epidemiol- ogy and management is key to improving equity of care. This review has identified gaps in knowledge that require further research.
BackgroundEvidence suggests there is variation in the diagnosis, management, and support for people with migraine. To improve equity of service, in line with the aspirations of public policy across the UK, it is imperative to understand how sociodemographic factors affect management and care of migraine.MethodsWe conducted a focused review of literature published between 2000-2021 to outline the evidence describing the relationship between the nine protected characteristics of the Equality Act 2010 and the epidemiology, diagnosis, management, and outcomes of migraine. Other factors such as deprivation, settlement status, education and employment were also explored.ResultsThere is much published literature on the relationship between age and sex in migraine epidemi- ology and management. There is good quality evidence regarding the large disability burden caused globally. There is limited evidence outlining the relationship between gender reassignment, ethnicity, religious and cultural factors, sexual orientation, settlement status, immigration and migraine. Further work should also focus on variation in access to specialist advice, and newer migraine treatments such as CGRP therapy.DiscussionBetter understanding of sociodemographic factors and their relationship with migraine epide- miology and management is key to improving equity of care. This review has identified gaps in knowledge that require further research.
IntroductionThis is the first known audit of Myasthenia Gravis (MG) conducted against the ABN 2015 guidelines. St. George’s Hospital is a tertiary neurosciences centre serving approximately 3 million.MethodsAll patients admitted with a diagnostic code of MG in 2018 were identified (n=59). Data relevant to ABN guidelines were collected from patient records.ResultsAverage time since diagnosis was 7 years (range 0–49). 56% had generalised myasthenia, 25% ocular myasthenia (OMG) and 19% were unspecified. Regarding investigations documented: neurophysi- ology 40%; serotype 58%; thymus imaging 54%; MRI brain 9/14 OMG. Regarding treatment: prednisolone in 61% (6/36 were on a higher than guideline recommended dose to control symptoms); bone protection in 24/36; immunosuppressant in 54%. Immunosuppression was indicated in 2/17 patients who were not on a steroid-sparing agent. Myasthenia was the primary reason for admission in 27/59. 55% of these inpatients had vital capacity monitoring documented. 81% had speech and language therapy.ConclusionThe ABN guidelines are relatively new considering disease duration in this cohort. A signifi- cant limitation is the assumption that if something was not documented in the electronic records, it was not done. A regional MDT has been created this year and re-audit is planned to determine its impact.m1701119@sgul.ac.uk
BackgroundTo improve equity of service, in line with the aspirations of public policy across the UK, it is imperative that we understand how sociodemographic factors affect the management and care of patients with motor neurone disease (MND).AimsTo describe the relationship between sociodemographic factors and the epidemiology, clinical factors, diagnosis, treatment, patient experience and outcomes for people with MND.MethodsWe conducted a focused review of published literature from 2000 to 2021 looking into MND and each of the patient protected characteristics, as outlined in the Equality Act 2010, with additional factors such as education, socioeconomic status and employment also included.ResultsThere is plenty of published literature exploring amyotrophic lateral sclerosis (ALS) and the rela- tionship with age, race, sex and gender.Minimal published data could be found for disability, gender reassignment, marriage and civil partner- ship, pregnancy and maternity, religion and beliefs, sexual orientation, socioeconomic status, settlement status, education and employment. Additionally, there was a lack of data looking into this for the different types of MND.DiscussionResearch in MND has focused heavily upon ALS. Further research into all patient protected characteristics and the different types of MND is required to improve equity in care and patient outcomes.
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