title: Decision-making for gastrostomy and ventilatory support for people with motor neurone disease: variations across UK hospices.
abstract: Interventions, such as the use of percutaneous endoscopic gastrostomy (PEG) and non-invasive ventilation (NIV), are used in the management of people with motor neurone disease with the aim of improving quality of life and relieving symptoms. However, the number of people receiving these interventions varies across the UK. This study has looked at the involvement and knowledge of consultants, within specialist palliative care services, with these procedures, to ascertain if there were differences in attitudes to their use. Twenty-two consultants took part in a telephone audit. There appeared to be great variation in their involvement in and knowledge of the use of these interventions. The majority of services were involved in the care of people with MND, but often only in the terminal stages. There appears to be a need for the wider application of guidelines on the use of PEG and NIV, as well as the development of a collaborative approach with other services, including neurology and rehabilitation services.
authors.affiliation: University of Kent, and Wisdom Hospice, High Bank, Rochester, Kent, UK ME1 2NU. drdjoliver@googlemail.com
authors.forename: David
authors.initials: D
authors.lastname: Oliver
authors.forename: Colin
authors.initials: C
authors.lastname: Campbell
authors.forename: Nigel
authors.initials: N
authors.lastname: Sykes
authors.forename: Carole
authors.initials: C
authors.lastname: Tallon
authors.forename: Annette
authors.initials: A
authors.lastname: Edwards
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D005774:Gastrostomy / Q000706:statistics & numerical data*; D006738:Hospices; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000628:therapy*; D010166:Palliative Care; D010818:Practice Patterns, Physicians'; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D006113:United Kingdom