P-10: Factors Influencing Prescription of Riluzole for ALS Patients in Ontario Home Care
Yong-Jin Kim*, George Heckman, Susan Horton, Christopher Perlman
University of Waterloo
Objective: To investigate factors associated with the use of riluzole in ALS patients in Ontario home care.
Methods: A retrospective cohort study was conducted in the Ontario Association of Community Care Access Centres' Home Care (OACCAC-HC) data. Assessment records of ALS patients admitted into home care between April 1st, 2005 and March 31st, 2013, who had information on the use of riluzole were reviewed. Baseline assessment data between non-riluzole to riluzole group were compared and multiple logistic regression was used to identify the predictors influencing the receipt of riluzole. Variables included in the multiple regression analysis were: age, gender, geographical location, marital status, caregiver availability, food consumption, swallowing, falls frequency, pressure ulcers, stair climbing, stamina, CPS scale, ADL Hierarchy Scale, IADL Involvement Scale, Pain Scale, Depression Rating Scale, and Changes in Health, End-Stage Disease, Signs, and Symptoms Scale.
Results: Among ALS patients (501 patients on riluzole vs. 776 patients not on riluzole), older age (OR: 0.97; 95%CI: 0.96-0.98), moderate-moderate severe impairment in cognitive functions (OR: 0.19; 95%CI: 0.07-0.53), and geographical location across LHINs (Erie St. Clair, South West, Waterloo Wellington, Hamilton Niagara Haldimand Brant, Mississauga Halton, South East, Champlain, and North East) decreased the likelihood of receipt of riluzole. Marital status (OR: 1.8; 95%CI: 1.27-2.52) increased the likelihood of receipt of riluzole.
Conclusion: A number of important predictors for riluzole prescription have been identified in this study. Such predictors could help develop policies or systematic guidelines for improving riluzole prescription.