Videofluoroscopic Dysphagia Scale as an Additional Indicator of Gastrostomy in Patients with Amyotrophic Lateral Sclerosis with Dysphagia

Shijo, Tomomi; Ikeda, Ryoukichi; Suzuki, Naoki; Ohta, Jun; Suzuki, Jun; Hirano-Kawamoto, Ai; Kato, Kengo; Ikeda, Kensuke S.; Izumi, Rumiko; Mitsuzawa, Shio; Warita, Hitoshi; Kato, Masaaki; Akiyama, Masashi; Katori, Yukio

doi:10.1620/tjem.2023.j005

Cited by 3 publications

(1 citation statement)

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“…There is a need to develop predictive tools that can inform HCPs and pwMND about the outcome of gastrostomy placement in relation to differing presentations of nutritional status, swallowing function and respiratory function. Such decision-support tools could facilitate timely decisions that prevent the development of malnutrition rather than react to it ( 5 , 38 , 39 ).…”

Section: Discussionmentioning

confidence: 99%

Supporting people with Motor Neuron Disease (MND) to make decisions about gastrostomy feeding tube placement: a survey of UK healthcare professionals’ practice and beliefs

White,

O’Cathain,

Halliday

et al. 2024

Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

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Objective Understand the practice and beliefs of healthcare professionals (HCPs) supporting the decision-making of people with MND (pwMND) about gastrostomy placement, including identifying differences between professions. Methods An online cross-sectional survey disseminated to HCPs who support the decision-making of pwMND about gastrostomy placement. Results A total of 139 participants completed the survey including representation from a range of healthcare professions. A third (36/101, 36%) initiated discussions about gastrostomy later in practice than they believed was ideal. In relation to the outcome of declining compared to accepting gastrostomy, participants were more likely to discuss aspiration (80% vs. 68%), choking (76% vs. 58%) and prognosis (36% vs. 22%). Participants believed gastrostomies should be placed after a mean 8.1% weight loss since symptom-onset. More participants favored gastrostomy placement before pwMND presented with respiratory symptoms (45%) compared to onset of dysphagia (11%). Half believed pwMND placed gastrostomies too late. Participants were more likely to ‘often’/‘always’ recommend pwMND to have a gastrostomy (23%) than continue without (7%) or decline (4%) gastrostomy, when believing these were the best option for pwMND. Nurses and dietitians discussed the broadest range of information, while doctors were more likely to discuss mortality risk and prognosis. Conclusion There is variation in HCPs practice and beliefs about initiating discussions, the sharing of information and recommendations, and timing, about gastrostomy placement. The information shared varies by profession and there is evidence of sub-optimal communication between HCPs. Further research is required to understand how these findings may impact on the decision-making of pwMND about gastrostomy.

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Section: Discussionmentioning

confidence: 99%