Alexander O’Connor

My Topol fellowship problem / project:

In patients with pelvic floor dysfunction, which includes constipation and incontinence, their symptoms are assessed using patient reported outcome measures (PROMs). These include symptom scores, quality of life questionnaires, and symptom diaries completed before and after interventions and in monitoring symptoms in the long-term.

Currently, PROMs are completed in paper form at several times during the patient’s treatment journey, which can last for years. However this data is not easily accessible and is often incomplete meaning patient assessment relies heavily on a finite number of conventional clinic appointments. In addition, patients can feel frustrated as they cannot access their data so are not empowered to monitor their own symptoms. By utilising a new electronic patient record system, my aim is to empower patients to prospectively record PROMs using the patient app before and after treatment, and during follow-up. Clinicians will therefore be able to assess patients and guide treatment decisions more easily. Further, by providing patients with easy access to their own data, and ability to report their symptoms, it will empower them to understand their condition and how it has responded to treatment.

Using this rich data, which is currently difficult to access, I aim to explore new ways of delivering care in partnership with patients and clinicians. This data can identify patients reporting deteriorating symptoms in need of urgent clinic assessment. At the same time, it can be used to offer reassurance to patients who may travel long distances but who are stable and require a short telephone call or written information. This will ensure hospital follow-up appointments are utilised efficiently, and patients achieve an improved understanding of their condition. Once established into routine practice, the data can then be used to inform research into the long-term outcomes of FI and the efficacy of treatments which are poorly understood.