scholarly journals 703 The Impact of Introducing A Patient Information Leaflet on Patient Experience of Safety Netting for Cauda Equina Syndrome at Lister Hospital

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Sravanam ◽  
M Vella-Baldacchino ◽  
J Kitson
Keyword(s):  
Back Pain ◽  
Patient Information ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Patient Information Leaflet ◽  
Medical Emergency ◽  
Medical Attention ◽  
Information Leaflet ◽  
Red Flag ◽  
Safety Netting

Abstract Introduction Cauda Equina Syndrome (CES) is a medical emergency. Patients with symptoms should seek medical attention immediately to prevent long-term neurological consequences. At our hospital, patients with back pain due to prolapsed vertebral discs are discharged with verbal advice about red-flag signs of CES. Studies have shown that patients retain only around half the information discussed in verbal consultations. Practice suggests that verbal advice combined with a patient information leaflet (PIL) allows for better safety-netting. Method In this study, we designed a new PIL reflecting latest British Association of Spinal Surgeons guidance. We then examined its impact on patient understanding and safety-netting of CES. Fifty patients who attended the Lister Hospital back pain service between September 2019 and August 2020 were randomly selected. Patients received a copy of the new PIL and were asked to complete a short questionnaire. Results Out of 26 respondents, over 86% (vs 59%) agreed/strongly agreed that the PIL helped them understand the red-flag signs of CES better. Furthermore, 81% said they felt better informed about CES than at the point of discharge from hospital. Conclusions This shows that the use of an effective way of educating patients about the red-flag signs of a medical emergency like CES.

scholarly journals 1499 The Statistical Value of Different Clinical Characteristics in Evaluation of Suspected Cauda Equina Syndrome

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
W Levitt ◽  
B Kamalakannan ◽  
Y Leung
Keyword(s):  
Back Pain ◽  
Cauda Equina Syndrome ◽  
Pain Sensitivity ◽  
Cauda Equina ◽  
Leg Pain ◽  
Statistical Association ◽  
Mri Findings ◽  
Leg Weakness ◽  
Red Flag ◽  
One Year

Abstract Introduction Cauda Equina Syndrome(CES) is a potentially disabling condition caused by compression of the thecal sac in the lumbar spine. Traditional teaching suggests red flags include back pain, sciatica, saddle anaesthesia and bladder disturbance. Current guidelines from the British Association of Spinal Surgeons recommend prompt investigation with MRI should these symptoms be present. Method A retrospective electronic case note review was undertaken from a one-year period to identify patients referred to the on call orthopaedic team with suspected CES and were investigated with MRI. Notes were reviewed for the presence of each clinical characteristic and correlated with MRI findings. Results 334 referrals underwent urgent MRI with 25 scans showing CES. Poor statistical association was observed with unilateral leg pain (sensitivity 0.28, specificity 0.48), back pain (sensitivity 0.92, specificity 0.13) and bladder dysfunction (sensitivity 0.72, specificity 0.36). Much closer statistical association was seen with bilateral leg pain (sensitivity 0.6, specificity 0.7, OR 5.03, 95% CI 2.16-11.68, p0.0002), leg weakness (sensitivity 0.68, specificity of 0.72, OR 5.35, 95% CI 2.23-12.85, p0.0002), leg sensory deficit (sensitivity 0.72, specificity 0.60, OR 3.79, 95% CI 1.54-9.36, p0.004) and altered perianal sensation (sensitivity 0.6, specificity 0.67, OR 3.03, 95% CI 1.31-6.99, p 0.009) Conclusions The diagnostic accuracy for some conventional red flag characteristics in CES is low. In our series back pain, unilateral sciatica and bladder disturbance showed low predictive value while bilateral sciatica, saddle anesthesia and lower limb sensorimotor deficits showed closer association and therefore should be closely evaluated for when reviewing such patients.

BET 2: Is sexual dysfunction a recognised sign of cauda equina syndrome in the ED?

2019 ◽  
Vol 36 (8) ◽  
pp. 508-510
Author(s):  
Michelle Angus ◽  
Daniel Horner
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sexual Dysfunction ◽  
Cauda Equina Syndrome ◽  
Search Strategy ◽  
Cauda Equina ◽  
Low Back ◽  
Red Flag ◽  
Study Type ◽  
New Onset

A shortcut review of the literature was carried out to examine the association of sexual dysfunction in the context of new-onset low back pain, with cauda equina syndrome (CES). Five papers were identified as suitable for inclusion using the reported search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated. It is concluded that clinicians appear to be poor at recording this feature during assessment, but between 12% and 96%, patients with confirmed CES will report the presence of new-onset sexual dysfunction at presentation when asked. It appears that this can also be a single isolated red flag feature in the context of low back pain and as such should be a mandatory part of any clinical assessment that seeks to evaluate the risk of impending CES.

scholarly journals Empowering Patients to Self-Manage Common Infections: Qualitative Study Informing the Development of an Evidence-Based Patient Information Leaflet

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1113
Author(s):  
Catherine V. Hayes ◽  
Bláthnaid Mahon ◽  
Eirwen Sides ◽  
Rosie Allison ◽  
Donna M. Lecky ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Pharmacy ◽  
Patient Information ◽  
Self Care ◽  
Theoretical Domains Framework ◽  
Patient Information Leaflet ◽  
Symptom Duration ◽  
Information Leaflet ◽  
Safety Netting ◽  
Common Infections

Common self-limiting infections can be self-managed by patients, potentially reducing consultations and unnecessary antibiotic use. This qualitative study informed by the Theoretical Domains Framework (TDF) aimed to explore healthcare professionals’ (HCPs) and patients’ needs on provision of self-care and safety-netting advice for common infections. Twenty-seven patients and seven HCPs participated in semi-structured focus groups (FGs) and interviews. An information leaflet was iteratively developed and reviewed by participants in interviews and FGs, and an additional 5 HCPs, and 25 patients (identifying from minority ethnic groups) via online questionnaires. Qualitative data were analysed thematically, double-coded, and mapped to the TDF. Participants required information on symptom duration, safety netting, self-care, and antibiotics. Patients felt confident to self-care and were averse to consulting with HCPs unnecessarily but struggled to assess symptom severity. Patients reported seeking help for children or elderly dependents earlier. HCPs’ concerns included patients’ attitudes and a lack of available monitoring of advice given to patients. Participants believed community pharmacy should be the first place that patients seek advice on common infections. The patient information leaflet on common infections should be used in primary care and community pharmacy to support patients to self-manage symptoms and determine when further help is required.

A comparative analysis of the lay-friendliness of Danish EU patient information leaflets from 2000 to 2012

2014 ◽  
Vol 11 (3) ◽  
Author(s):  
Inger Askehave ◽  
Karen Korning Zethsen
Keyword(s):  
Comparative Analysis ◽  
Patient Information ◽  
Patient Information Leaflet ◽  
General Interest ◽  
Information Leaflet ◽  
Empirical Results ◽  
Patient Information Leaflets ◽  
Information Leaflets ◽  
The Subject ◽  
The Eu

Since becoming mandatory in the EU in 1992, the patient information leaflet (PIL) has been the subject of an on-going discussion regarding its ability to provide easily understandable information. This study examines whether the lay-friendliness of Danish PILs has improved from 2000 to 2012 according to the Danish consumers. A reproduction of a questionnaire study from 2000 was carried out. The responses of the 2012 survey were compared to those of the 2000 survey and the analysis showed that Danes are less inclined to read the PIL in 2012 compared to 2000 and that the general interest in PILs has decreased. The number of respondents who deem the PIL easy to read has gone down. According to Danish consumers, the lay-friendliness of PILs has not improved from 2000 to 2012 and a very likely explanation could be that the PIL as a genre has become far too regulated and complex to live up to its original intentions. On the basis of the empirical results the article furthermore offers suggestions for practice changes.

The role of clinical pharmacist in enhancing the health-related quality of life in patients with pulmonary tuberculosis

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Eldhose Varghese ◽  
Irrin Poulose ◽  
Chaitanya Sagar G ◽  
Jennifer Ann Jose ◽  
Mintu Mathew Ms
Keyword(s):  
Quality Of Life ◽  
Pulmonary Tuberculosis ◽  
Patient Information ◽  
Patient Information Leaflet ◽  
Information Leaflet ◽  
Patient Counselling ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Tuberculosis (TB) is potentially airborne severe infectious disease which requires long term treatment. It considerably affects the physical and mental health quality of the patient’s life. Appropriate patient counselling with the help of Patient Information Leaflet will help to improve the patient’s quality of life and overall treatment outcome. To enhance the health related quality of life in pulmonary tuberculosis patients by providing patient counselling with the aid of patient information leaflet. An interventional study was carried out for six months in 80 patients diagnosed with pulmonary tuberculosis from the OP & IP of Tuberculosis and Chest Department of a medical college hospital. The HRQoL was assessed using the SF-36 questionnaire. Appropriate patient counselling was provided with the help of Patient Information Leaflet. In our study, a total of 80 patients were enrolled, out of which 49[61%] were Out-patients, and 31[39%] were In-patients. All the 8 sub domains of the SF-36 survey show statistical significance with improvement in 2nd Visit (after counselling) when compared with the baseline visit. The demographic variables like smoking, low socioeconomic status, allergies, family history show statistically significant association with overall HRQoL. The HRQOL of the pulmonary tuberculosis patients were initially low before the start of Anti-TB therapy, after providing proper patient counselling using patient information leaflet the HRQoL scores were found to be increased on the subsequent re-visits, which implies the need of proper patient counselling and follow-up in PTB for the better quality of life.

Just the facts: Risk stratifying nontraumatic back pain for Cauda Equina Syndrome in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 652-654
Author(s):  
Zoe Polsky ◽  
Margriet Greidanus ◽  
Anjali Pandya ◽  
W. Bradley Jacobs
Keyword(s):  
Emergency Department ◽  
Back Pain ◽  
Cauda Equina Syndrome ◽  
Bowel Movement ◽  
Chronic Back Pain ◽  
Cauda Equina ◽  
Digital Rectal Examination ◽  
Acute Onset ◽  
Clinical Exam ◽  
History Of

A 43-year-old male, with a history of chronic back pain, presents to the emergency department (ED) with acute onset chronic pain. He states he “tweaked something” and has been debilitated by back pain, radiating down both his legs, for 24 hours. He has not had a bowel movement but denies noticing any “saddle anesthesia.” His clinical exam is limited by pain, and it is difficult to determine if he has objective weakness. His perineal sensation is intact, as is his sensation upon digital rectal examination. The patient has a post-void residual of 250 mL, but you are unsure how to interpret this value. As an emergency physician, when should you suspect, and how should you evaluate cauda equina syndrome?

Sign in / Sign up

Export Citation Format

Share Document