Session number: 1130
Abstract title: A Survey of Veterans with Spinal Cord Injury (SCI) Concerning Outcomes Related to Neurogenic Bowel
Author(s):
S Luther - University of South Florida Health Sciences Center, Center for Health Outcomes Research
A Nelson -
H Bosshart -
S Burns -
L Goetz -
K Gerhart -
J Harrow MD -
B Simmons -
Objectives: To describe the self-reported patient outcomes related to neurogenic bowel in veterans with spinal cord injury (SCI).
Methods: A self-administered written questionnaire was developed as part of a project to evaluate the impact of clinical practice guidelines for neurogenic bowel management of adults with spinal cord injury. All veterans who were exposed to guideline-based treatment at six participating VAMCs (selected to be representatives of the 23 VA SCI centers) were mailed a questionnaire pre-intervention and post-intervention. A description of common bowel-related outcome measures from the pre-intervention (baseline) survey (n = 1,238) was conducted and will be presented. Examples of measures to be discussed include:1) a description of the respondents current bowel care program, 2) patient satisfaction and compliance with prescribed bowel care regimen, and 3) adverse events related to neurogenic bowel management, such as falls/pressure ulcers related to use of bowel care equipment.
Results: The majority of respondents (59.7%) reported completing bowel care independently. Nearly three quarters of the respondents (74.7%) indicated they had started a bowel care program after their injury, most commonly in the hospital (35.4%) or in SCI rehabilitation (29.6%). Most respondents (61.6%) indicated that they adhered to the prescribed program 75% to100% of the time during the past month. Approximately 1 in 10 (10.3%) indicated that the bowel management program had been changed by their health care provider in the last year. Over 6% of the patients reported pressure ulcers and 7% reported falls directly related to use of equipment for neurogenic bowel management.
Conclusions: The current study represents one of the largest most comprehensive surveys of SCI patients regarding nuerogeninc bowel outcomes. The results should provide Veterans Administration clinicians and administrators new insights into the current status of this important aspect of care for SCI patients.
Impact statement: Neurogenic bowel is common after SCI, with 95% prevalence reported in the literature. Up to 23% of individuals with chronic SCI have required hospitalization for evaluation or treatment of complications of neurogenic bowel and 5-10% of the deaths associated with SCI are due to gastrointestinal complications. Optimal control of the condition is an important part of providing good care to the 20,000 persons with SCI who receive care from the Veterans Administration annually.