027 The prevalence and management of saliva problems in motor neuron disease

IntroductionSaliva problems are common in people with motor neuron disease (pwMND). Despite guide- lines for assessment and treatment, management of saliva problems has received little research attention.ObjectiveTo investigate the prevalence of saliva problems in pwMND, their association with clinical factors and their management practice.MethodsWe conducted an analysis of pwMND diagnosed between January 2015 and October 2019 using the Scottish MND Register (CARE-MND). The association between clinical factors and saliva problems was investigated using univariate and multivariable logistic regression. A survey of relevant healthcare professionals was performed to contextualise findings.Results939 pwMND were included. Saliva problem prevalence was 37.5% (294). Bulbar onset (P<0.001) but not age, sex, time to diagnosis and MND subtype were independently associated with presence of saliva problems in multivariable regression. 60.3% (155) pwMND with saliva problems received pharmacological management. The most used medications were hyoscine, amitriptyline, carbocisteine, glycopyrrolate and atropine. Evidence-base (72.7%) and local guidelines (90.9%) were cited as the most important factors influencing treatment decision by survey respondents (n=11).ConclusionSaliva problems are associated with bulbar onset MND. Many pwMND with saliva problems did not receive recommended treatments. Future research is required to determine the relative efficacy of individual pharmacological treatments.s1505898@ed.ac.uk