MDC03
Interdisciplinary Approach to Bowel and Bladder Care for Individuals with MS
Neurogenic bowel and bladder have been reported as common and disabling symptoms in multiple sclerosis (Preziosi & Gordon-Dixon, 2018). The presence of either or both impact quality of life (QOL), daily activities and employment status (Preziosi & Gordon-Dixon, 2018). These issues are complicated to address, require trial and error and the expertise of many different healthcare providers. In our current health care system, it can be difficult for the person living with MS to navigate through these appointments, medications and recommendations independently. As recommended by CMSC following a consensus conference, having patients participate in “shared medication appointments” might be an effective appropriate to address bowel and bladder concerns in this population(Namey & Halper, 2012).
Objectives:
To provide comprehensive and integrative bowel and bladder treatment to individuals with multiple sclerosis from a multi-disciplinary team including a medical provider (MD or APP), pelvic floor physical therapist, occupational therapist, registered nurses, and other specialists as needed.
Methods:
An integrative team of healthcare professionals reviewed the current literature on bowel and bladder care for individuals with MS. It was determined through the review of literature and patient report in the MS clinic at Shepherd Center that patients’ bowel and bladder concerns were not being adequately addressed in the current model of care. Literature suggested taking a comprehensive approach to bowel and bladder care. An integrative team of healthcare professionals including nursing, occupational therapy, physical therapy, management, pelvic floor therapy, and an advanced practice provider collaborated to develop a patient screening form, algorithm for addressing bowel and bladder concerns, and a comprehensive clinic structure using literature and resources within Shepherd Center. Outcome measures were chosen and administered to capture the efficacy of this comprehensive clinic and approach. Services provided through this clinic were reallocated from within Shepherd Center and captured through the electric medical record, Epic, already in place.
Results:
Results of several individuals will be shared including outcome measures of QOL and bowel and bladder function. Additionally lessons learned and take always of providing this type of shared appointments will be discussed.
Conclusions:
An integrative and comprehensive approach may be an effective approach to addressing bowel and bladder concerns in individuals with MS and improve QOL in this population.