Factors associated with assistive technology prescription and acceptance in motor neurone disease

PurposeThe risk of delaying assistive technology (AT) prescription and implementation has significant implications on the safety and quality of life of people with Motor Neurone Disease (PwMND). This study aims to explore the barriers and enablers of AT prescription and implementation identified by PwMND and clinicians.MethodsA qualitative study using semi-structured focus groups with clinicians and in-depth interviews with PwMND. Sixteen clinicians and ten PwMND were recruited. Thematic analysis was completed and results were compared and discussed to reach an agreement on the final themes.ResultsThree main factors were identified - PwMND, Clinician and Extrapersonal. For PwMND, personal characteristics, such as mindset, was the strongest enabler and inability to accept diagnosis and AT was the key barrier. For Clinician, communication approach was both the most identified enabler and barrier. For Extrapersonal, the availability of interactive education of AT was the strongest enabler and long wait time was a significant barrier.ConclusionOur study identified themes that clinicians could have an impact on, such as, providing interactive education, engaging PwMND and their support network, and ongoing upskilling of clinicians working in this field. Themes identified that were beyond the control of clinicians were personal characteristics, acceptance and support networks. It highlights the importance for clinicians to be flexible with their communication approach to accommodate the needs of PwMND in the acceptance of AT. There are many factors that may influence a person with Motor Neurone Disease's decision about Assistive Technology (AT) and not all are within the control of clinicians.It is important for clinicians to be reflective of the situation and barriers they encounter, and recognise their limits and what they can act on.For clinicians looking after people with Motor Neurone Disease (PwMND), it is important to develop your knowledge continuously, consider setting up an AT library, and engage PwMND and their support network in care decision making.