Factors influencing implementation of cognitive and behavioural screening in motor neurone disease

Changes in cognition and behaviour occur in approximately 50% of people with amyotrophic lateral sclerosis (ALS), the most common form of motor neurone disease (MND). The aim of this study was to explore current factors influencing the implementation of cognitive and behavioural screening in MND care in the UK. Semi-structured interviews with healthcare professionals working in a range of settings were conducted and data were analysed thematically. In most of the settings included, a pathway to screening and neuropsychological intervention had not yet been established. Factors identified as barriers included: limited number of staff trained to administer screen; limited time available during outpatient clinic hours; and limited or no links with neuropsychological services. Screening was implemented routinely in one setting where there was support from a clinical neuropsychologist working within the MDT. Support from neuropsychological services was suggested to be necessary for interpretation of screening results and advice on intervention.