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ABN Abstracts 2022
Poster presentations
202 Frequency of inter-specialty consensus decisions and adherence to advice following a weekly neurovascular multidisciplinary meeting
  1. C Offiah1,2,
  2. S Tierney3,
  3. B Egan3,
  4. DR Collins2,4,
  5. DJ Ryan2,4,
  6. AJ McCarthy1,2,
  7. DR Smith1,5,
  8. E Boyle3,
  9. H Delaney6,
  10. DJH McCabe,
  11. on behalf of the TUH/AMNCH NV MDT Team1,2,5,7,8
  1. 1Dept. of Neurology
  2. 2Stroke Service
  3. 3Dept. of Vascular Surgery
  4. 4Dept. of Age-Related Health
  5. 5Vascular Neurology Research Foundation
  6. 6Dept. of Radiology, Tallaght University Hospital (TUH)/AMNCH, Dublin
  7. 7Dept. of Clinical Neurosciences, Royal Free Campus, UCL Queen Square Institute of Neurology, London
  8. 8Academic Unit of Neurology, School of Medicine, Trinity College Dublin

Abstract

Background/Aims Data are limited on the frequency of ‘consensus’ between sub-specialists attending a neurovascular multidisciplinary meeting (MDM) regarding management of patients with extracranial carotid/vertebral stenoses, and post-MDM ‘adherence’ to advice. This prospective audit/quality improve- ment project collated data at a Neurovascular/Stroke Centre.

Methods Data from a weekly MDM were prospectively-recorded to document the proportion of extrac- ranial carotid/vertebral stenosis patients in whom ‘consensus management decisions’ were reached by Neurologists/Vascular Surgeons/Stroke Physicians-Geriatricians. Adherence to MDM advice was analysed in patients with asymptomatic, symptomatic and ‘indeterminate symptomatic status [ISS]’ stenoses, including intervals between symptom onset-MDM discussion +/- intervention.

Results 115 patients were discussed (September/2017-February/2020). Consensus regarding manage- ment was 96.5% (111/115) overall; 100% (29/29) with asymptomatic carotid stenosis [ACS], 96.5% (55/57) with symptomatic carotid stenosis [SCS], and 93.1% (27/29) with ISS. Overall adherence to MDM advice was 93% (107/115); 100% (29/29) with ACS, 89.5% (51/57) with SCS, 93.1% (27/29) with ISS. Median interval from index TIA/stroke to intervention was 12.5 days (IQR:9-18d), and MDM discussion-to-intervention was 5.5d (IQR:1-7d) in patients with 50-99% SCS.

Conclusions High-frequency inter-specialty consensus regarding management/adherence to proposed treatment supports a collaborative, multidisciplinary model-of-care in patients with extracranial arterial stenosis. Service development should shorten intervals between symptoms-MDT discussion-intervention to optimise secondary prevention.

https://doi.org/10.1136/jnnp-2022-abn2.246

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