Validation of the Monitoring Efﬁcacy of Neurogenic Bowel Treatment on Response (MENTOR) Tool in a Japanese Rehabilitation Setting

Journal of Clinical Medicine, 2021 · DOI: 10.3390/jcm10050934 · Published: March 1, 2021

Spinal Cord Injury Gastroenterology Rehabilitation

Simple Explanation

This study validates a tool called MENTOR for assessing bowel dysfunction in people with spinal cord injury or spina bifida in Japan. The MENTOR tool helps identify if someone's bowel treatment is adequate, needs discussion, or needs change. The study found the MENTOR tool to be useful in a Japanese rehabilitation setting, helping to identify those needing further treatment.

Study Duration

January 2020 to July 2020

Participants

60 individuals with SCI (57) and spina bifida (3)

Evidence Level

Prospective observational study

Key Findings

1
The MENTOR tool showed acceptable concordance with physician decisions regarding treatment adequacy and the need for treatment change.
2
The MENTOR tool was easy to understand and complete, taking approximately 4.1 minutes on average.
3
The study identified an association between each of the three components of the MENTOR tool (NBD score, SAS, and patient satisfaction) and the recommendation for change in treatment.

Research Summary

The study validated the MENTOR tool in a Japanese rehabilitation setting for individuals with SCI or spina bifida suffering from NBD. The results showed acceptable concordance between the MENTOR tool's assessment and the treatment decisions made by expert physicians, particularly for identifying individuals who were adequately treated or required a change in treatment. The MENTOR tool was found to be easy to use and understand, suggesting its potential for facilitating discussions between patients and physicians and improving NBD treatment.

Practical Implications

Improved Identification of NBD Treatment Needs

The MENTOR tool can help identify individuals with SCI who may be unaware of the severity of their NBD symptoms, facilitating discussions with physicians and potentially leading to improved treatment.

Facilitation of Stepwise Treatment Approach

The MENTOR tool can assist clinicians in assessing and identifying when a patient should revise their current NBD treatment following a stepwise approach, ensuring appropriate and timely interventions.

Potential for Broader Application

The MENTOR tool could be utilized by physicians and caregivers in non-hospital settings to monitor the worsening of NBD symptoms in individuals with SCI and identify the potential requirement for further management.

Study Limitations

1
The study was conducted in only one rehabilitation clinic in the Hyogo prefecture of Japan, which may limit the generalizability of the findings to other regions.
2
The study did not provide specific information on which components of the MENTOR tool (e.g., SAS) led to individuals being placed in the yellow zone, making it difficult to fully explain why treatment changes were not recommended for this group.
3
Lack of long-term follow-up data to assess whether the MENTOR tool improves symptoms, reduces hospitalizations, or affects other comorbidities.

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