Predicting response to a community‐based educational workshop on incontinence among community‐dwelling older women: Post hoc analysis of the CACTUS‐D trial
Open Access
- 5 February 2021
- journal article
- research article
- Published by Wiley in Neurourology and Urodynamics
- Vol. 40 (2), 705-713
- https://doi.org/10.1002/nau.24614
Abstract
Aims Our goal was to identify which women participating in an educational workshop on incontinence were most likely to benefit from it. Methods We included women aged 65 or older, living in the community, and not treated for incontinence despite reporting urinary leakage at least twice a week. The workshop's aims were to change beliefs about accepting incontinence as a normal part of ageing, explain that incontinence is not irreversible, and that solutions exist. We performed structured interviews at 6 and 12 months to assess impressions of improvement (PGI-I) and changes in both continence (ICIQ-FLUTS) and quality of life (I-QOL). Results The analysis included 392 women, 39% aged 80 or older and 57% with daily urinary incontinence. Twelve months after the workshop, 16% of women were "much better" (PGI-I); factors associated with impression of improvement were refusal to believe that incontinence is part of normal ageing at baseline and improvement of urinary symptoms. The median improvement was 4 points on the ICIQ-FLUTS and 8 on the I-QOL. Factors associated with a clinically significant improvement in urinary symptoms were more severe baseline urinary incontinence, obesity, and starting Kegel exercises. Factors associated with a clinically significant improvement in quality of life were a poor urinary quality of life at baseline and an age younger than 81 years. Conclusions A short, inexpensive and nonmedical intervention can change the mind-set and behavior of older women with incontinence who are not seeking care. A clinically significant improvement is possible even in women with severe symptoms.Funding Information
- Economic and Social Research Council
- Canadian Institutes of Health Research
This publication has 15 references indexed in Scilit:
- The Effect of Urinary Incontinence on Health-related Quality of Life: Is It Similar in Men and Women?Urology, 2016
- Continence Across Continents To Upend Stigma and Dependency (CACTUS-D): study protocol for a cluster randomized controlled trialTrials, 2015
- Implications of the Minimal Clinically Important Difference for Health-Related Quality-of-Life Outcomes: A Comparison of Sample Size Requirements for an Incontinence Treatment TrialValue in Health, 2015
- Stress urinary incontinence treatment—surgery first?Nature Reviews Urology, 2013
- Effectiveness of continence promotion for older women via community organisations: a cluster randomised trialBMJ Open, 2013
- Knowledge and understanding of urinary incontinence: survey of family practitioners in northern Alberta.2013
- Urinary incontinence and risk of functional decline in older women: data from the Norwegian HUNT-studyBMC Geriatrics, 2013
- Peer support and improved quality of life among persons living with HIV on antiretroviral treatment: A randomised controlled trial from north-eastern VietnamHealth and Quality of Life Outcomes, 2012
- Rating improvements in urinary incontinence: do patients and their physicians agree?Age and Ageing, 2008
- Quality of life of women with urinary incontinence: further development of the incontinence quality of life instrument (I-QOL)Urology, 1999