Studsgaard Slot Sofie Dagmar, Baunwall Simon Mark Dahl, Emmanuel Anton, Christensen Peter, Krogh Klaus
Department of Hepatology and Gastroenterology, Aarhus University Hospital of Aarhus, DK8200 Aarhus N, Denmark.
GI Physiology Unit, University College Hospital, London NW1 2BU, UK.
J Clin Med. 2021 Jan 12;10(2):263. doi: 10.3390/jcm10020263.
Most patients with a spinal cord injury (SCI) suffer from neurogenic bowel dysfunction (NBD). In spite of well-established treatment algorithms, NBD is often insufficiently managed. The Monitoring Efficacy of Neurogenic bowel dysfunction Treatment On Response (MENTOR) has been validated in a hospital setting as a tool to support clinical decision making in individual patients. The objective of the present study was to describe clinical decisions recommended by the MENTOR (either "monitor", "discuss" or "act") and the use of the tool to monitor NBD in a non-hospital setting.
A questionnaire describing background data, the MENTOR, ability to work and participation in various social activities was sent by mail to all members of The Danish Paraplegic Association.
Among 1316 members, 716 (54%) responded, 429 men (61%) and 278 women (39%), aged 18 to 92 (median 61) years. Based on MENTOR, the recommended clinical decision is to monitor treatment of NBD in 281 (44%), discuss change in treatment in 175 (27%) and act/change treatment in 181 (28%). A recommendation to discuss or change treatment was associated with increasing age of the respondent ( = 0.016) and with impaired ability to work or participate in social activities ( < 0.0001).
A surprisingly high proportion of persons with SCI have an unmet need for improved bowel care. The MENTOR holds promise as a tool for evaluation of treatment of NBD in a non-hospital setting.
大多数脊髓损伤（SCI）患者患有神经源性肠功能障碍（NBD）。尽管有成熟的治疗方案，但NBD的管理往往不够充分。神经源性肠功能障碍治疗反应监测（MENTOR）已在医院环境中得到验证，可作为支持个体患者临床决策的工具。本研究的目的是描述MENTOR推荐的临床决策（“监测”、“讨论”或“采取行动”）以及该工具在非医院环境中监测NBD的应用情况。
通过邮件向丹麦截瘫协会的所有成员发送了一份描述背景数据、MENTOR、工作能力和参与各种社会活动情况的问卷。
在1316名成员中，716名（54%）做出了回应，其中男性429名（61%），女性278名（39%），年龄在18至92岁（中位数61岁）之间。根据MENTOR，推荐的临床决策是对281名（44%）患者的NBD治疗进行监测，对175名（27%）患者讨论治疗方案的改变，对181名（28%）患者采取行动/改变治疗方案。建议讨论或改变治疗方案与受访者年龄的增加（ = 0.016）以及工作或参与社会活动能力受损（ < 0.0001）有关。
令人惊讶的是，有相当高比例的SCI患者对改善肠道护理有未满足的需求。MENTOR有望成为在非医院环境中评估NBD治疗的工具。
