The results of a study carried out at Bellvitge Hospital by Dr Mónica Povedano for her doctoral dissertation reinforce the value of centralised care for the disease
The implementation of a multidisciplinary care model has a positive and direct impact on the survival and satisfaction rates of patients with amyotrophic lateral sclerosis (ALS). People cared for in a unit made up of professionals from different disciplines achieve an increase in survival of 6 months on average, according to the work carried out by Dr Mónica Povedano for her doctoral dissertation.
In the dissertation, which she presented a few days ago, Dr Povedano has collected different data from almost 400 patients treated at the University Hospital of Bellvitge, 54 of them attended by a general neurologist between 1991 and 2000, and 344 who were treated by the Functional Unit of Motor Neurone Disease (UFMM in Catalan) between 2001 and 2012. According to the application of different analysis models, the main variables that made possible the increase in the average survival of patients are the suitable application of respiratory support and of gastrostomy (which allows the supply of food directly into the stomach), as well as the duration of both processes.
In terms of satisfaction with the care provided at the UFMM, 92% of patients rated the information received, the respect for their rights as patients, the coordination and treatment as good or very good. The UFMM at Bellvitge Hospital is made up of professionals from neurology; pulmonology; rehabilitation and physiotherapy; nutrition and dietetics; psychology (thanks to the collaboration with the Catalan ALS Foundation Miquel Valls); occupational therapy; social work; epidemiology; nursing and palliative care. Thus, on the same day, the patient is seen consecutively by all the specialists in the unit.
Dr Povedano’s work deals with the change in the clinical approach to ALS patients, this change’s impact on survival, as well as on the correlation between environmental factors and the disease.
According to Dr Povedano, coordinator of the UFMM, the experience and data from the multidisciplinary unit argue for a centralised care model for a minority disease such as ALS, as well as for others. "The results of the survey indicate that patients who live further away do not show worse survival figures and do not represent an added increase in healthcare costs for the centre," Dr Povedano points out.
In this sense, the doctoral dissertation also refutes the belief that ALS patient care causes a very high direct cost for health centres. The average of this direct expenditure is 5,574 euros per patient per year, according to the study of 425 patients treated at the UFMM of the Bellvitge University Hospital between 2016 and 2019. On the other hand, Dr Povedano's work indicates that this individual cost becomes higher the closer the centre is to the patient and the lower the patient's level of education is. "This confirms the need to make an effort to improve health education and patients' knowledge of their disease," concludes Dr Povedano.
Moreover, the survey also identifies some twenty locations in Catalonia where environmental variables, such as the presence of certain agricultural chemical products and the proximity of strategic road infrastructures with a high traffic density, may have a special relevance.