Research by Dr Anaïs Thouin

All of our attendees carry out a piece of research in an area of MS clinical practice or treatment that interests them.

If you would like to contact Dr Thouin, drop us a line and we’ll put you in touch where possible.

Aim

To determine whether clinic appointments give people with MS an opportunity to discuss their sexual health, and to suggest strategies to encourage clinicians to enquire into sexual function, to better support people with MS.

Headlines

  • NICE guideline 186 (1.6.3) gives the criterion ‘Bladder, bowel and sexual function should be assessed as part of a yearly comprehensive review…’
  • Studies suggest only 2-6% of patients have discussed or been asked about sexual function by the primary MS doctor.
  • Over an audit period of Jan 2015-18 the research standard was to have 50% of people with MS offered opportunity to discuss their sexual function during their yearly review.
  • Findings were gathered through an audit which reviewed:
    • notes from consecutive follow-up appointments during the audit period
    • all letters by the MS team concerning bladder, bowel and sexual function
    • Additional information that might be relevant to sexual function such as antidepressant use

Key findings

  • Sexual function was hardly ever assessed or discussed (1/30 patients) though risk factors for sexual dysfunction were present such as:
    • spinal symptoms
    • relatively high level of disability (median EDSS 5.5)
    • relatively common antidepressant use (30%+)
  • Enquiry into bladder and bowel symptoms was not universal or not possible to discern from the letter reviewed.
  • Sexual function is important to patients and sexual dysfunction is common but under-recognised and under-treated.
  • Recognition of sexual dysfunction could be improved through:
    • identifying barriers to discussion such as embarrassment, lack of time or lack of access to resources.
    • identifying an intervention that would improve the likelihood of the topic being discussed such as giving patients a list of common symptoms on booking into the clinic to tick the areas they most want to discuss.

Core recommendations

  • Put together an advice sheet including a list of available resources.
  • Liaise with the local Sexual Assault Referral Centre (SARC) regarding practical advice and what should be clinical practice before referring patients on.
  • Repeat the audit in due course.

 

Take action

  • Read the full report.
  • See the full slide set from Dr Thouin’s presentation here.
  • Contact the researcher to discuss their work (please put the name of the Snapshot as your title in our contact form)
  • Learn more about the issues raised in this report. Click the scattered links to access further information.