• Atencion primaria · Dec 2021

    Observational Study

    [Amyotrophic lateral sclerosis (ALS) from the perspective of Primary Care. Epidemiology and clinical-care characteristics].

    • Emilia Castro-Rodríguez, Rafael Azagra, Xavier Gómez-Batiste, and Mónica Povedano.
    • PADES Delta de Llobregat, Institut Català de la Salut, El Prat de Llobregat, Barcelona, España.
    • Aten Primaria. 2021 Dec 1; 53 (10): 102158102158.

    UnlabelledAmyotrophic Lateral Sclerosis (ALS) is a rare disease in primary care (PC), it represents a challenge for the family doctor, especially in home care.ObjectiveTo know the incidence and prevalence of ALS in an area of ??PA management, the clinical characteristics and use of health resources.DesignObservational study.LocationPC-Direction Costa de Ponent, South Metropolitan Health Region, Barcelona, Catalonia, Spain.ParticipantsPatients with ALS ≥18 years diagnosed until 03/01/2017. Main measurements Age, sex, characteristics: form of appearance (spinal, bulbar, others), interval between onset of symptoms and diagnosis, percutaneous gastrostomy carriers, ventilation non-invasive or invasive. Identification in PC as a Complex Chronic Patient or with palliative needs (CCP). Inclusion in home care programs (PAD). Model of attention hospitable.Results81 patients, mean age 65.6 years (± 11.7), men 49.4%. Shape of onset: spinal 69%, bulbar 21%, another 4%. Interval between the onset of symptoms and diagnosis 12 months. Identified as a CCP 13.6%, 29 patients (35.8%) included in PAD. Attended in comprehensive hospital model 79 patients (97.5%). Prevalence 6.1/100,000 inhabitants in 2017. Annual incidence between 1.2 cases/100,000 inhabitants/year in 2012 and 3.5 cases/100,000 inhabitants/year in 2016.ConclusionsThe use of percutaneous gastrostomy in ALS favors the identification as CCP or with palliative needs and inclusion in PAD. The use of non-invasive ventilation favors inclusion in PAD. The incidence and prevalence data for ALS are higher than those described above in the same area. Early identification is necessary of these patients in the chronic care models in PC teams.Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

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