More than 80% of individuals with motor neurone disease (MND) develop problems with swallowing. This can make it harder to eat and drink, with the potential to cause significant distress, choking risk and weight loss. One way of managing this is to have a feeding tube fitted into the stomach through a procedure known as a gastrostomy. Food, drink and medicines can be delivered directly into the body through the tube.
Although this seems a good solution, there is very little evidence around whether tube feeding improves nutrition in people with MND, whether it lengthens life or if it improves quality of life. Some people have concerns about having a feeding tube fitted or what it's like to live with one and may decide it is not the right choice for them.
The aim of this project was to develop a web-based decision aid to help people with MND decide whether to have a feeding tube fitted. A decision aid presents accurate and reliable information, clearly explains the risks and benefits associated with each possible choice and checks understanding. Decision aids also help people understand what is most important to them, so they support people to make decisions which fit their values.
This project followed internationally agreed guidelines for developing a decision aid. We looked at previous research and resources which were already available. Crucially, we also interviewed people with MND, carers and healthcare professionals to make sure we included the right information and presented it in the best way possible. The decision aid was improved by asking people with MND, carers and healthcare professionals to review it after each round of changes. We then tested the decision aid across the country to make sure that patients, carers and clinicians found it helpful and easy to use. We also checked if patients thought it had helped them come to the right decision for them.
As the decision aid is web-based, the final version can be shared widely, ensuring that it reaches the people and organisations who need it most. It can now be accessed via the MND Association website.
Analysis and Write Up