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Electronic questionnaire improves reporting of continence issues

Dr Heidi Beadnall

Bladder or bowel symptoms commonly occur in MS. The symptoms, including incontinence from the bladder or bowel, can have a profound effect upon an individual’s quality of life and self-esteem. If left untreated some urinary problems can have serious long term effects. Although research has highlighted the benefit in treating bladder or bowel problems, symptoms are often disregarded or tolerated by the individual, and overlooked or poorly managed by health professionals.

Neurologist and PhD student Dr Heidi Beadnall recently published a study in the journal Annals of Clinical and Translational Neurology, looking at the use of a tablet-based screening tool for identifying continence issues in people with MS.

This study was based in the MS clinic in the Brain and Mind Centre at the University of Sydney. Dr Beadnall is currently receiving a MS Research Australia postgraduate scholarship for her other work looking at the use of magnetic resonance imaging (MRI) to measure brain tissue loss in MS.

Dr Beadnall and colleagues used an electronic version of two questionnaires (the Bladder Control Scale and the Bowel Control Scale) loaded onto a tablet computer. In this study, 157 MS patients completed the questionnaire in their neurologist’s waiting room. The questionnaires took on average 1 minute each to complete, and results were transferred wirelessly into each patient’s health record and could immediately be accessed by their neurologist.

Most importantly, for any patient whose answers indicated possible bladder or bowel difficulties, the program would automatically generate an electronic referral to the clinic’s on-site MS continence nurse for detailed follow-up. Of the 157 people who completed the questionnaire, the program generated 128 referrals to the continence nurse for follow-up.

This study shows promising early results supporting a new method for allowing people with MS to provide information about their symptoms. Electronic questionnaires may be a more comfortable way for people to reveal incontinence issues that may otherwise remain untreated. Of those who visited the specialist nurse for follow-up, over 40% indicated that without the questionnaire they would not otherwise have mentioned their incontinence symptoms to their doctor.

The researchers at this clinic, led by Associate Professor Michael Barnett, are also undertaking a range of investigations into different types of e-health, including the use of tablet-based screening for a range of under-reported MS symptoms such as cognitive difficulties, as well as providing a telemedicine video conferencing facility for people living in regional areas of NSW.

Another team of researchers led by Professor Helmut Butzkueven at the University of Melbourne, in a current MS Research Australia-funded project, are conducting an Australia and New Zealand-wide survey of bladder and bowel dysfunction to provide good-quality information about the types of bladder and bowel symptoms and how common they are among people with MS in Australia. This information is vital to complement studies such as Dr Beadnall’s, and enable neurologists and MS nurses to most effectively manage these symptoms in people with MS.

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Electronic questionnaire improves reporting of continence issues