urinary incontinence
Conditions
Interventions
In this pragmatic trial the intervention is designed as close as possible to treatment options in clinical practice (including ‘cascades’ of patient management choices). This way implementation in the
Sponsors
None
Eligibility
Inclusion criteria
Inclusion criteria: All consecutive patients consulting their GP within 1 year for symptoms and signs of stress, urge and mixed urinary incontinence (according to the guidelines of the Dutch College of General Practitioners on urinary incontinence are eligible for the study .
Exclusion criteria
Exclusion criteria: 1. Excluded will be patients below 18; 2. Women with prolaps degree III or more; 3. Patients with signs of reflex- or verflow incontinence; 4. Patients with tumours in the abdomen; 5. Patients with severe neurological diseases associated with incontinence (multiple sclerosis; 6. CVA; 7. Diabetes, cauda equina syndrome); 8. Actual urinary tract infection; 9. Hematuria without urinary tract infection; 10. Man below 65 with unclear reason for incontinence; 11. Failure after operation or failure of conservative therapy; 12. Severe cognitive problems; 13. Patients not well versed in the Dutch language; 14. Patients who refuse to participate/cooperate; 15. Patients for whom the GP considers the management via the nurse practitioner as impossible/undesired, or unexpected circumstances not related to the trial (such as moving away, sickness).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Severity of involuntary loss of urine: measured by the self-completed condition specific International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) which measures frequency, volume and impact on daily life of involuntary urine loss (see supplement for questions and scoring). The outcome is a sum score of the first two weighted items and the VAS score of impact on daily life. The questionnaire underwent extensive psychometric testing. It is expected that the International Consultation on Incontinence (ICI) will rate this questionnaire as Grade A, meaning highly recommendable; 2. Medical costs (the use of diagnostics, treatment and incontinence pads) and non-medical costs (productivity costs, time costs and travel costs): collected using both registration systems and cost diaries during four weeks. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Quality of life: Condition specific self-completed quality of life questionnaire: International Incontinence Questionnaire (IIQ): this in Dutch validated 30 items questionnaire measures impact of urinary loss on five domains: ‘mobility’, ‘physical functioning’, ‘social functioning’, ‘emotional health’ and ‘embarrassment’. b) Generic self-completed quality of life questionnaire; 2. Quantification of symptoms relevant for urinary incontinence (the degree of pad usage times of micturation, voided volumes, incontinence episodes, fluid intake, the degree of urgency, complications, complaints): measured with a self completed bladder diary during 3 consecutive days; 3. Patients satisfaction with provided care by the GP and/or the nurse practitioner for urinary incontinence will be measured with the for urinary incontinence adjusted QUOTE self completed questionnaire; 4. Perceptions of GPs about the availability and involvement of the route via the nurse practitioner: data of a sample of participating GPs will be collected by semi-structured interview and/or questionnaires before, once during the first 2 months and after the study about ideas/expectations, promoting and /or hampering factors for (not) using the nurse practitioner and experiences in relation to quality of care with the nurse practitioner; 5. Perceptions of nurse practitioners: data of participating nurse practitioners will be collected with semi-structured interview and/or questionnaires before, during and after the study about ideas/expectations and experiences in relation to quality of care. | — |
Contacts
Public ContactRon A.G. Winkens
University Hospital Maastricht, Integrated care unit (Bze-7), P.O. Box 5800
Outcome results
None listed