Multidisciplinary team clinic for vocal cord dysfunction directs therapy and significantly reduces healthcare utilization
| Autor: | Kais Hamza, Malcolm Baxter, Elizabeth Leahy, Emily Heke, Philip G. Bardin, Kathy Low, Debra Phyland, Kenneth K. Lau, Martin MacDonald, Laurence Ruane |
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| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Larynx Male medicine.medical_specialty Laryngoscopy Diagnostic Techniques Respiratory System Physical examination Medical Overuse Diagnosis Differential 03 medical and health sciences Otolaryngology 0302 clinical medicine medicine Vocal cord dysfunction Humans Medical history 030212 general & internal medicine Prospective Studies Intersectoral Collaboration Asthma Patient Care Team medicine.diagnostic_test business.industry Australia Emergency department Middle Aged Patient Acceptance of Health Care medicine.disease medicine.anatomical_structure 030228 respiratory system Vocal Cord Dysfunction Emergency medicine Female business Cohort study |
| Zdroj: | Respirology (Carlton, Vic.). 24(8) |
| ISSN: | 1440-1843 |
| Popis: | BACKGROUND AND OBJECTIVE Multidisciplinary team (MDT) clinics use an integrated approach to individualize care of complex medical conditions. Vocal cord dysfunction (VCD) is a challenging condition that is likely to benefit from MDT clinics but this has not been researched. METHODS A prospective observational cohort study of a novel VCD MDT clinic was conducted in patients with suspected VCD. Relevant questionnaires, medical history, physical examination, spirometry, dynamic computerized tomography (CT) larynx and laryngoscopy were utilized and patients were allocated to treatment pathways depending on putative diagnosis. Speech pathology intervention with laryngeal retraining (LR) was offered and if LR therapy failed botulinum toxin injection was offered. Primary outcome was reductions in healthcare utilization. RESULTS Overall, 80 consecutive patients were included in analyses. A definitive diagnosis of VCD was made in 56 of 80 (70%) patients. After LR (n = 35), emergency department (ED)/hospital admissions declined significantly in the subsequent 12 months (P = 0.001). General practice visits also reduced (P |
| Databáze: | OpenAIRE |
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