Brucker Benjamin M, Nitti Victor W, Kalra Sidhartha, Herbert Joseph, Sadiq Areeba, Utomo Puspa, Aponte Margarita M
Department of Urology, NYU Langone Medical Center, New York, New York.
Department of Neurology, NYU Langone Medical Center, New York, New York.
Neurourol Urodyn. 2017 Apr;36(4):1208-1213. doi: 10.1002/nau.23101. Epub 2016 Aug 22.
The Actionable Bladder Symptom and Screening Tool (ABSST) is used to identify multiple sclerosis (MS) patients in possible need of evaluation for urinary symptoms. The primary objective of this study was to identify barriers experienced by MS patients in seeking evaluation for urinary symptoms. We also assessed the utility of ABSST tool in identifying patients that will follow up with urologic evaluation.
This was a prospective observational study where 100 patients with MS were enrolled from an MS center. Patients completed demographic information, questions to assess barriers to care, a short form of the ABSST, and incontinence questionnaires. An ABSST score >3 met criteria for referral and evaluation. One year after enrollment, follow up calls assessed whether patients had seen a urinary specialist.
The most common barriers to seeking care included "Doctor never referred" (16%) and "Doctor never asked" (13%). Thirty-eight percent (n = 8/21) of men stated "Doctor never referred" compared to 10% (n = 8/79) of women (P = 0.002). Twenty-seven patients had an ABSST Score ≥3 and were more interested in seeing a specialist compared to those scoring <3 (88.9%, n = 24/27 vs. 26%, n = 19/73; P = <0.001). After 1 year, 70 patients were reached for follow up. A total of 57.9% (n = 11/19) patients who followed up for evaluation screened positive on the ABSST.
The ABSST is a valuable tool to identify MS patients with urinary symptoms who will likely follow up for genitourinary evaluation. However, other barriers beyond awareness exist and prevent patients from being evaluated.
可行动膀胱症状与筛查工具（ABSST）用于识别可能需要对泌尿系统症状进行评估的多发性硬化症（MS）患者。本研究的主要目的是确定MS患者在寻求泌尿系统症状评估时遇到的障碍。我们还评估了ABSST工具在识别将接受泌尿外科评估的患者方面的效用。
这是一项前瞻性观察性研究，从一个MS中心招募了100例MS患者。患者完成了人口统计学信息、评估护理障碍的问题、ABSST简表和失禁问卷。ABSST评分>3符合转诊和评估标准。入组一年后，随访电话评估患者是否看过泌尿专科医生。
寻求护理最常见的障碍包括“医生从未转诊”（16%）和“医生从未询问”（13%）。38%（n = 8/21）的男性表示“医生从未转诊”，而女性为10%（n = 8/79）（P = 0.002）。27例患者的ABSST评分≥3，与评分<3的患者相比，他们对看专科医生更感兴趣（88.9%，n = 24/27 vs. 26%，n = 19/73；P = <0.001）。1年后，70例患者接受了随访。共有57.9%（n = 11/19）接受评估随访的患者在ABSST上筛查呈阳性。
ABSST是一种有价值的工具，可用于识别有泌尿系统症状且可能会接受泌尿生殖系统评估随访的MS患者。然而，除了认知方面，还存在其他障碍，阻碍了患者接受评估。
