Incontinence-associated Dermatitis
Conditions
Keywords
urinary incontinence, fecal incontinence, copper
Brief summary
As there are currently no evidence on the benefit of absorbing incontinence products with copper to stabilize IAD in the elderly, thus, this study will assess the capacity and safety of an absorbing incontinence products with a copper-based substance for the management of adults with incontinence-associated dermatitis, compared to an absorbing incontinence products with no substance. This approach may contribute for IAD management arsenal, since clinical evidence on the efficiency of products available in the market to manage IAD is frail, as seen in systematic reviews mentioned above. We believe copper, as a barrier product, has the potential to perform well in this clinical setting of IAD, as it performed well in other settings.
Detailed description
This study adopts an exploratory trial design with an adaptive approach. It is randomized, multicenter, controlled, and double-blinded, with parallel groups and blinded outcome adjudication. The study hypothesis suggests that incontinence products infused with copper-based substances may provide superior stabilization of IAD compared to control products. The primary objective of the study is to evaluate the effectiveness of absorbing incontinence products containing a copper-based substance in stabilizing incontinence-associated dermatitis (IAD) in adults with moderate to severe urinary and/or fecal incontinence. This will be compared against standard absorbing incontinence products without copper-based substances, with both groups receiving usual care. Secondary objectives include assessing improvements in pain within 14 and 28 days, evaluating quality of life improvements over 28 days, and measuring changes in skin health scores from baseline to 14 and 28 days. Participants will be adults aged 60 years or older, experiencing moderate to severe urinary and/or fecal incontinence. Eligibility will be determined using specific scales outlined in the study rationale. Recruitment will target individuals in long-term care facilities or hospital wards located within São Paulo municipality and its metropolitan area in Brazil. Feasibility assessments will be conducted at each site during an initial visit. Sites deemed suitable will then proceed with participant recruitment. This study seeks to address critical aspects of managing IAD, particularly through innovative copper-based products. By focusing on clinical endpoints such as pain reduction, quality of life enhancements, and improvements in skin health, the trial aims to provide evidence supporting the potential benefits of copper-infused incontinence products over traditional alternatives.
Interventions
COMBINATION_PRODUCTDiaper with a copper-based product + usual care
The intervention is an incontinence aid product and its performance is related to its ability to absorb and contain urine/ feces as well as keeping the skin dry.
COMBINATION_PRODUCTBarrier product with common diaper
The common diaper is an incontinence aid and its performance is related to its ability to absorb and contain urine/ feces as well as keeping the skin dry.
Sponsors
Essity Hygiene and Health AB
Hospital Israelita Albert Einstein
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Intervention model description
Adaptative Design, Randomized, Multicenter, Controlled, Double-Blinded Exploratory trial
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Ability and capability to participate in the study and follow study procedures as determined by the investigator. * With moderate or more intense urinary (ISI ≥ 3) and/or fecal incontinence (Pescatori et al. (B1, B2, B3, C1, C2, C3); * Current users of absorbing incontinence products. * Diagnosed with incontinence-associated dermatitis GLOBIAD 1A or 2A.
Exclusion criteria
* Incontinence-associated dermatitis GLOBIAD 1B or 2B; * The subject who knows about allergy or a history of an adverse reaction to product ingredients or to any topical preparations or skincare products; * The subject who has an active skin condition or a history of recurrent skin conditions, except IAD, that may affect IAD healing; * The subject who was treated in the previous week with systemic or topical agents (except for IAD) that may affect IAD healing process (e.g., steroids); * Subject with a score \< 10 in Mini Nutritional Assessment - Short Form; * Subjects with diabetes.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of non-progressing IAD 14 days | 14 days | Proportion of non-progressing IAD after 14 days from randomization start by GLOBIAD criterion. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain assessment | 14 and 28 days | Pain assessment using the numerical scale in 14 and 28 days; the scales goes from 0, for no pain, to 10, for the worst pain ever felt by the patient. |
| Quality of life SF12 | 28 days | Quality of life assessment in the 28th day (Short-Form 12 Health Survey). The maximum score is 100, and the higher the better. |
| Proportion of non-progressing IAD 28 days | 28 days | Proportion of non-progressing IAD after 28 days from randomization start by GLOBIAD criterion. |
| Time to resolution of IAD | From enrollment to resolution, mean of 4 to 7 days | Time to resolution of IAD |
| Reoccurrence of IAD | From resolution of the first episode of IAD to the 28th day | Reoccurrence of IAD during the follow-up of 28 days |
| Skin health by skin health assessment tool | 14 and 28 days | The skin health of the subjects after 14 and 28 days using the skin health assessment tool, a visual assessment tool with no ordinal scale. |
Outcome results
None listed