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Multi-centre audit of myotonic dystrophy care in UK: is it the time for national recommendations?
  1. Mohit Litesh1,2,
  2. Paul R Campbell3,
  3. Sadaf Mehboob4,
  4. Frederick Vonberg5,
  5. Woon Senn Koh5,
  6. Phillip Kelly3,
  7. Priya Shanmugarajah4,
  8. Stuart Viegas5,
  9. James B Lilleker3,
  10. Channa Hewamadduma1,2
  1. 1Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield
  2. 2Sheffield Teaching Hospitals NHS Foundation Trust
  3. 3Northern Care Alliance NHS Foundation Trust
  4. 4Leeds Teaching Hospitals NHS Trust
  5. 5Imperial College Healthcare NHS Trust

Abstract

Myotonic Dystrophy Type 1 (DM1) is the most common muscular dystrophy in adults. Structured multi- disciplinary care is required to manage the multi-system involvement, to improve patient safety, and to reduce mortality and morbidity. Previous audits based on the 2018 consensus-based care recommenda- tions have been conducted at individual UK centres. In this study a standardised audit tool was created and deployed to 3 tertiary UK neuroscience centres.

In total, data regarding 375 patients (197 (53%) female, mean age 47 years (range 1-84)) with DM1 were analysed. 62% had adult-onset disease. Neurology teams reviewed 64% of patients at least once a year. Key findings included: Cardiology review was performed annually for only 30%; of patients with respiratory needs, only 12% were reviewed six-monthly by specialist teams; Swallowing function was assessed in only 44% of those required; Clinical assessment for cognitive impairment was conducted in 12%.

In conclusion, this multi-centre UK audit identifies several significant areas of care that need to be optimised in DM1, even within dedicated neuromuscular clinics. This highlights the need for a national initiative to establish minimum care standards. Such initiative can help drive resource allocation resulting in positive change.

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