Abstract
Background: Sialorrhoea is the increase of drooling due to poor clearance of saliva and is a common symptom in people with Parkinson’s Disease. It can lead to a decline in confidence, as well as increasing the risk of aspiration pneumonia. Botulinum injections are currently used in select patients to control the sialorrhoea, and the purpose of this project was to assess the benefit this treatment has had on patients.
Methods: Data was collected from 40 patients who have received treatment at the sialorrhoea clinic and included Drooling Severity and Frequency Scale (DSFS), EQ5D and Visual Analogue score (VAS) - quality of life scores that are routinely collected before and after each injection. Using the Welsh Clinical Portal, data was collected on mood, swallow problems, dementia and comorbidities.
Results: Out of a total of 86 injections, 66 resulted in a decreased DSFS score showing better controlled sialorrhoea after most injections. Among the discharged patients, there was an equal distribution between those discharged due to successful and unsuccessful treatment (n=9 each). In 74% of successful injections it took less than a week to take effect and 63% of successful injections lasted 3 months or longer. The average onset of sialorrhoea after a Parkinson’s Disease diagnosis was 7.7 years and out of 40 patients, 11 experienced low mood and 19 had swallowing difficulties before treatment. Over a cumulative 40 years of treatment across all patients, there were only 4 reported admissions due to pneumonia.
Conclusion: Most injections resulted in an improved DSFS score with the average decrease in the score being 1.9 in successful injections. As many patients with sialorrhoea experience low mood, effectively controlling the sialorrhoea can improve patients’ quality of life and confidence, as well as reducing hospital admissions due to aspiration pneumonia.