PMID- 12842055
OWN - NLM
STAT- MEDLINE
DCOM- 20030819
LR  - 20220331
IS  - 1470-0328 (Print)
IS  - 1470-0328 (Linking)
VI  - 110
IP  - 7
DP  - 2003 Jul
TI  - Randomised controlled trial of nurse continence advisor therapy compared with 
      standard urogynaecology regimen for conservative incontinence treatment: 
      efficacy, costs and two year follow up.
PG  - 649-57
AB  - OBJECTIVE: To compare the efficacy and labour costs of nurse continence advisors 
      and urogynaecologists in conservative management of urinary incontinence. DESIGN: 
      Single centre randomised controlled trial of patients with mild or moderate 
      leakage. SETTING: Tertiary urogynaecology unit. SAMPLE: One hundred and 
      forty-five consecutive patients with stress and/or urge incontinence. METHODS: 
      Standardised conservative therapy regimens, provided by nurse continence advisors 
      and urogynaecologists. MAIN OUTCOME MEASURE: One-hour pad test, frequency volume 
      charts, a 20-point incontinence score and two quality of life tests, staff 
      treatment times and costs. RESULTS: Of 110 women who completed 12-week 
      treatments, 64% of the women in the nurse continence advisor group (n = 58) and 
      52% of women treated by urogynaecologists (n = 52) were asymptomatic (dry pad 
      test; OR 1.63, 95% CI 0.71-3.75). There was no significant difference between 
      clinician groups for change in pad test result (P = 0.71), voids/day (0.43), 
      incontinence score (P = 0.57) or quality of life scores (urogenital distress 
      inventory, P = 0.27; Incontinence Impact Questionnaire, P = 0.41). Despite the 
      expected longer consultation times for the advisor group (median 160 min, 
      interquartile range [IQR] 130-210) versus the urogynaecologist group (median 90 
      min, IQR 60-120), the per capita labour cost for advisor treatment (median 
      AU$59.20, IQR 48.10-77.70) was lower than for treatment given by 
      urogynaecologists (median cost AU$ 189.70, IQR 120.60-250.70, Mann-Whitney U 
      test, P < 0.0001). At 2.5 years, 23/58 patients (40%) treated by advisor and 
      27/52 patients (52%) treated by urogynaecologist group, who had been cured and 
      discharged, were available for contact. Of these, 29% of women in the nurse 
      continence advisor group and 41% of those treated by urogynaecologists remained 
      continent (on 20-point score). Quality of life improvement persisted equally in 
      both groups. These data should be interpreted cautiously due to a 24% dropout 
      rate. CONCLUSIONS: The reduction in urine leakage and improvement in quality of 
      life observed in patients treated by nurse continence advisors and 
      urogynaecologists were similar at 12 weeks and 2 years, but lower costs arose 
      from treatment provided by nurse advisors. We suggest that conservative treatment 
      by the nurse continence advisor could be used more widely in mild to moderate 
      incontinence.
FAU - Moore, K H
AU  - Moore KH
AD  - Pelvic Floor Unit, St George Hospital, University of New South Wales, Sydney, New 
      South Wales 2217, Australia.
FAU - O'Sullivan, R J
AU  - O'Sullivan RJ
FAU - Simons, A
AU  - Simons A
FAU - Prashar, S
AU  - Prashar S
FAU - Anderson, P
AU  - Anderson P
FAU - Louey, M
AU  - Louey M
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - BJOG
JT  - BJOG : an international journal of obstetrics and gynaecology
JID - 100935741
SB  - IM
MH  - Aged
MH  - Ambulatory Care
MH  - Cost of Illness
MH  - Cost-Benefit Analysis
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Middle Aged
MH  - Quality of Life
MH  - Time Factors
MH  - Treatment Outcome
MH  - Treatment Refusal
MH  - Urinary Incontinence/economics/*nursing/physiopathology
MH  - Urination/physiology
MH  - Women's Health Services
EDAT- 2003/07/05 05:00
MHDA- 2003/08/20 05:00
CRDT- 2003/07/05 05:00
PHST- 2003/07/05 05:00 [pubmed]
PHST- 2003/08/20 05:00 [medline]
PHST- 2003/07/05 05:00 [entrez]
AID - S1470032803029641 [pii]
PST - ppublish
SO  - BJOG. 2003 Jul;110(7):649-57.