PubTransformer

A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

Behavioural interventions for urinary incontinence in community-dwelling seniors: an evidence-based analysis.

Abstract In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors.
PMID
Related Publications

Community-based care for the management of type 2 diabetes: an evidence-based analysis.

Behavioural interventions for type 2 diabetes: an evidence-based analysis.

Social isolation in community-dwelling seniors: an evidence-based analysis.

Prevention of falls and fall-related injuries in community-dwelling seniors: an evidence-based analysis.

Caregiver- and patient-directed interventions for dementia: an evidence-based analysis.

Authors

Mayor MeshTerms
Keywords
Journal Title ontario health technology assessment series
Publication Year Start
%A Health Quality Ontario
%T Behavioural interventions for urinary incontinence in community-dwelling seniors: an evidence-based analysis.
%J Ontario health technology assessment series, vol. 8, no. 3, pp. 1-52
%D 10/2008
%V 8
%N 3
%M eng
%B In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors.
%P 1
%L 52
%W PHY
%G AUTHOR
%R 2008........8....1.

@Article{HealthQualityOntario2008,
author="{Health Quality Ontario}",
title="Behavioural interventions for urinary incontinence in community-dwelling seniors: an evidence-based analysis.",
journal="Ontario health technology assessment series",
year="2008",
month="Oct",
day="01",
volume="8",
number="3",
pages="1--52",
abstract="In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas\_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors.",
issn="1915-7398",
url="http://www.ncbi.nlm.nih.gov/pubmed/23074508",
language="eng"
}

%0 Journal Article
%T Behavioural interventions for urinary incontinence in community-dwelling seniors: an evidence-based analysis.
%A Health Quality Ontario
%J Ontario health technology assessment series
%D 2008
%8 October 01
%V 8
%N 3
%@ 1915-7398
%G eng
%F HealthQualityOntario2008
%X In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors.
%U http://www.ncbi.nlm.nih.gov/pubmed/23074508
%P 1-52

PT Journal
AU Health Quality Ontario
TI Behavioural interventions for urinary incontinence in community-dwelling seniors: an evidence-based analysis.
SO Ontario health technology assessment series
JI Ont Health Technol Assess Ser
PD 10
PY 2008
BP 1
EP 52
VL 8
IS 3
LA eng
AB In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors.
ER

PMID- 23074508
OWN - NLM
STAT- PubMed-not-MEDLINE
DA  - 20121017
DCOM- 20121018
LR  - 20151026
IS  - 1915-7398 (Electronic)
IS  - 1915-7398 (Linking)
VI  - 8
IP  - 3
DP  - 2008
TI  - Behavioural interventions for urinary incontinence in community-dwelling seniors:
      an evidence-based analysis.
PG  - 1-52
AB  - In early August 2007, the Medical Advisory Secretariat began work on the Aging in
      the Community project, an evidence-based review of the literature surrounding
      healthy aging in the community. The Health System Strategy Division at the
      Ministry of Health and Long-Term Care subsequently asked the secretariat to
      provide an evidentiary platform for the ministry's newly released Aging at Home
      Strategy.After a broad literature review and consultation with experts, the
      secretariat identified 4 key areas that strongly predict an elderly person's
      transition from independent community living to a long-term care home.
      Evidence-based analyses have been prepared for each of these 4 areas: falls and
      fall-related injuries, urinary incontinence, dementia, and social isolation. For 
      the first area, falls and fall-related injuries, an economic model is described
      in a separate report.Please visit the Medical Advisory Secretariat Web site,
      http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to
      review these titles within the Aging in the Community series.AGING IN THE
      COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related
      Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural
      Interventions for Urinary Incontinence in Community-Dwelling Seniors: An
      Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for
      Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling
      Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario 
      Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To assess the effectiveness
      of behavioural interventions for the treatment and management of urinary
      incontinence (UI) in community-dwelling seniors. CLINICAL NEED: TARGET POPULATION
      AND CONDITION Urinary incontinence defined as "the complaint of any involuntary
      leakage of urine" was identified as 1 of the key predictors in a senior's
      transition from independent community living to admission to a long-term care
      (LTC) home. Urinary incontinence is a health problem that affects a substantial
      proportion of Ontario's community-dwelling seniors (and indirectly affects
      caregivers), impacting their health, functioning, well-being and quality of life.
      Based on Canadian studies, prevalence estimates range from 9% to 30% for senior
      men and nearly double from 19% to 55% for senior women. The direct and indirect
      costs associated with UI are substantial. It is estimated that the total annual
      costs in Canada are $1.5 billion (Cdn), and that each year a senior living at
      home will spend $1,000 to $1,500 on incontinence supplies. Interventions to treat
      and manage UI can be classified into broad categories which include lifestyle
      modification, behavioural techniques, medications, devices (e.g., continence
      pessaries), surgical interventions and adjunctive measures (e.g., absorbent
      products). The focus of this review is behavioural interventions, since they are 
      commonly the first line of treatment considered in seniors given that they are
      the least invasive options with no reported side effects, do not limit future
      treatment options, and can be applied in combination with other therapies. In
      addition, many seniors would not be ideal candidates for other types of
      interventions involving more risk, such as surgical measures. NOTE: It is
      recognized that the terms "senior" and "elderly" carry a range of meanings for
      different audiences; this report generally uses the former, but the terms are
      treated here as essentially interchangeable. DESCRIPTION OF TECHNOLOGY/THERAPY:
      Behavioural interventions can be divided into 2 categories according to the
      target population: caregiver-dependent techniques and patient-directed
      techniques. Caregiver-dependent techniques (also known as toileting assistance)
      are targeted at medically complex, frail individuals living at home with the
      assistance of a caregiver, who tends to be a family member. These seniors may
      also have cognitive deficits and/or motor deficits. A health care professional
      trains the senior's caregiver to deliver an intervention such as prompted
      voiding, habit retraining, or timed voiding. The health care professional who
      trains the caregiver is commonly a nurse or a nurse with advanced training in the
      management of UI, such as a nurse continence advisor (NCA) or a clinical nurse
      specialist (CNS). The second category of behavioural interventions consists of
      patient-directed techniques targeted towards mobile, motivated seniors. Seniors
      in this population are cognitively able, free from any major physical deficits,
      and motivated to regain and/or improve their continence. A nurse or a nurse with 
      advanced training in UI management, such as an NCA or CNS, delivers the
      patient-directed techniques. These are often provided as multicomponent
      interventions including a combination of bladder training techniques, pelvic
      floor muscle training (PFMT), education on bladder control strategies, and
      self-monitoring. Pelvic floor muscle training, defined as a program of repeated
      pelvic floor muscle contractions taught and supervised by a health care
      professional, may be employed as part of a multicomponent intervention or in
      isolation. Education is a large component of both caregiver-dependent and
      patient-directed behavioural interventions, and patient and/or caregiver
      involvement as well as continued practice strongly affect the success of
      treatment. Incontinence products, which include a large variety of pads and
      devices for effective containment of urine, may be used in conjunction with
      behavioural techniques at any point in the patient's management. EVIDENCE-BASED
      ANALYSIS METHODS: A comprehensive search strategy was used to identify systematic
      reviews and randomized controlled trials that examined the effectiveness, safety,
      and cost-effectiveness of caregiver-dependent and patient-directed behavioural
      interventions for the treatment of UI in community-dwelling seniors (see Appendix
      1). RESEARCH QUESTIONS: Are caregiver-dependent behavioural interventions
      effective in improving UI in medically complex, frail community-dwelling seniors 
      with/without cognitive deficits and/or motor deficits?Are patient-directed
      behavioural interventions effective in improving UI in mobile, motivated
      community-dwelling seniors?Are behavioural interventions delivered by NCAs or
      CNSs in a clinic setting effective in improving incontinence outcomes in
      community-dwelling seniors? ASSESSMENT OF QUALITY OF EVIDENCE: The quality of the
      evidence was assessed as high, moderate, low, or very low according to the GRADE 
      methodology and GRADE Working Group. As per GRADE the following definitions
      apply: HighFurther research is very unlikely to change confidence in the estimate
      of effect.ModerateFurther research is likely to have an important impact on
      confidence in the estimate of effect and may change the estimate.LowFurther
      research is very likely to have an important impact on confidence in the estimate
      of effect and is likely to change the estimate.Very LowAny estimate of effect is 
      very uncertain SUMMARY OF FINDINGS: Executive Summary Table 1 summarizes the
      results of the analysis. The available evidence was limited by considerable
      variation in study populations and in the type and severity of UI for studies
      examining both caregiver-directed and patient-directed interventions. The UI
      literature frequently is limited to reporting subjective outcome measures such as
      patient observations and symptoms. The primary outcome of interest, admission to 
      a LTC home, was not reported in the UI literature. The number of eligible studies
      was low, and there were limited data on long-term follow-up. Executive Summary
      Table 1:Summary of Evidence on Behavioural Interventions for the Treatment of
      Urinary Incontinence in Community-Dwelling SeniorsInterventionTarget
      PopulationInterventionsConclusionsGRADE quality of the evidence1.
      Caregiver-dependent techniques (toileting assistance)Medically complex, frail
      individuals at home with/without cognitive deficits and/or motor
      deficitsDelivered by informal caregivers who are trained by a nurse or a nurse
      with specialized UI training (NCA/CNS)Prompted voidingHabit retrainingTimed
      voidingThere is no evidence of effectiveness for habit retraining (n=1 study) and
      timed voiding (n=1 study).Prompted voiding may be effective, but effectiveness is
      difficult to substantiate because of an inadequately powered study (n=1
      study).Resource implications and caregiver burden (usually on an informal
      caregiver) should be considered.Low2. Patient-directed techniquesMobile,
      motivated seniorsDelivered by a nurse or a nurse with specialized UI training
      (NCA/CNS)Multicomponent behavioural interventionsInclude a combination ofBladder 
      trainingPFMT (with or without biofeedback)Bladder control
      strategiesEducationSelf-monitoringSignificant reduction in the mean number of
      incontinent episodes per week (n=5 studies, WMD 3.63, 95% CI,
      2.07-5.19)Significant improvement in patient's perception of UI (n=3 studies, OR 
      4.15, 95% CI, 2.70-6.37)Suggestive beneficial impact on patient's health-related 
      quality of lifeModerate PFMT aloneSignificant reduction in the mean number of
      incontinent episodes per week (n=1 study, WMD 10.50, 95% CI,
      4.30-16.70)Moderate3. Behavioural interventions led by an NCA/CNS in a clinic
      settingCommunity-dwelling seniorsBehavioural interventions led by NCA/CNSOverall,
      effective in improving incontinence outcomes (n=3 RCTs + 1 Ontario-based
      before/after study)Moderate*CI refers to confidence interval; CNS, clinical nurse
      specialist; NCA, nurse continence advisor; PFMT, pelvic floor muscle training;
      RCT, randomized controlled trial; WMD, weighted mean difference; UI, urinary
      incontinence. ECONOMIC ANALYSIS: A budget impact analysis was conducted to
      forecast costs for caregiver-dependent and patient-directed multicomponent
      behavioural techniques delivered by NCAs, and PFMT alone delivered by
      physiotherapists. (ABSTRACT TRUNCATED)
CN  - Health Quality Ontario
LA  - eng
PT  - Journal Article
DEP - 20081001
PL  - Canada
TA  - Ont Health Technol Assess Ser
JT  - Ontario health technology assessment series
JID - 101521610
PMC - PMC3377527
OID - NLM: PMC3377527
EDAT- 2008/01/01 00:00
MHDA- 2008/01/01 00:01
CRDT- 2012/10/18 06:00
PHST- 2008/10/01 [epublish]
PST - ppublish
SO  - Ont Health Technol Assess Ser. 2008;8(3):1-52. Epub 2008 Oct 1.
TY  - JOUR
AU  - Health Quality Ontario
PY  - 2008/10/01
TI  - Behavioural interventions for urinary incontinence in community-dwelling seniors: an evidence-based analysis.
T2  - Ont Health Technol Assess Ser
JO  - Ontario health technology assessment series
SP  - 1
EP  - 52
VL  - 8
IS  - 3
N2  - In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors.
SN  - 1915-7398
UR  - http://www.ncbi.nlm.nih.gov/pubmed/23074508
ID  - HealthQualityOntario2008
ER  - 
<?xml version="1.0" encoding="UTF-8"?>
<b:Sources SelectedStyle="" xmlns:b="http://schemas.openxmlformats.org/officeDocument/2006/bibliography"  xmlns="http://schemas.openxmlformats.org/officeDocument/2006/bibliography" >
<b:Source>
<b:Tag>HealthQualityOntario2008</b:Tag>
<b:SourceType>ArticleInAPeriodical</b:SourceType>
<b:Year>2008</b:Year>
<b:Month>10</b:Month>
<b:Day>01</b:Day>
<b:PeriodicalName>Ontario health technology assessment series</b:PeriodicalName>
<b:Volume>8</b:Volume>
<b:Issue>3</b:Issue>
<b:Pages>1-52</b:Pages>
<b:Author>
<b:Author><b:NameList>
<b:Person><b:Last>Health Quality Ontario</b:Last></b:Person>
</b:NameList></b:Author>
</b:Author>
<b:Title>Behavioural interventions for urinary incontinence in community-dwelling seniors: an evidence-based analysis.</b:Title>
 <b:ShortTitle>Ont Health Technol Assess Ser</b:ShortTitle>
<b:Comments>In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry&apos;s newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person&apos;s transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors.</b:Comments>
</b:Source>
</b:Sources>