Effectiveness of a newly developed online self‐management program for male patients with uncomplicated lower urinary tract symptoms

Blanker, Marco H.; Admiraal, Anja; Brandenbarg, Pim; Steffens, M.G.; Balken, Michael R. van; Mulder, H. Buitenhuis en S.A.; Worp, Henk van der

doi:10.1002/nau.24131

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…A non-randomised pilot study of men with uncomplicated LUTS in secondary care gave access to an online self-management programme in the intervention arm, versus usual care from a urologist. 22 No significant differences was found between cohorts for the IPSS, and uptake of the intervention was only 53%. A randomised trial determined the effects of a health education strategy for older adults living at home, providing a booklet on five common health problems, including LUTS, 23 and found that the health education strategy did not change visits to a doctor within three months.…”

Section: Discussionmentioning

confidence: 93%

“…We did not identify other studies of similar size directed at this issue. A non-randomised pilot study of men with uncomplicated LUTS in secondary care gave access to an online self-management programme in the intervention arm, versus usual care from a urologist 22. No significant differences was found between cohorts for the IPSS, and uptake of the intervention was only 53%.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of lower urinary tract symptoms in men in primary care using a conservative intervention: cluster randomised controlled trial

Drake,

Worthington,

Frost

et al. 2023

BMJ

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Objective To determine whether a standardised and manualised care intervention in men in primary care could achieve superior improvement of lower urinary tract symptoms (LUTS) compared with usual care. Design Cluster randomised controlled trial. Setting 30 National Health Service general practice sites in England. Participants Sites were randomised 1:1 to the intervention and control arms. 1077 men (≥18 years) with bothersome LUTS recruited between June 2018 and August 2019: 524 were assigned to the intervention arm (n=17 sites) and 553 were assigned to the usual care arm (n=13 sites). Intervention Standardised information booklet developed with patient and expert input, providing guidance on conservative and lifestyle interventions for LUTS in men. After assessment of urinary symptoms (manualised element), general practice nurses and healthcare assistants or research nurses directed participants to relevant sections of the manual and provided contact over 12 weeks to assist with adherence. Main outcome measures The primary outcome was patient reported International Prostate Symptom Score (IPSS) measured 12 months after participants had consented to take part in the study. The target reduction of 2.0 points on which the study was powered reflects the minimal clinically important difference where baseline IPSS is <20. Secondary outcomes were patient reported quality of life, urinary symptoms and perception of LUTS, hospital referrals, and adverse events. The primary intention-to-treat analysis included 887 participants (82% of those recruited) and used a mixed effects multilevel linear regression model adjusted for site level variables used in the randomisation and baseline scores. Results Participants in the intervention arm had a lower mean IPSS at 12 months (adjusted mean difference −1.81 points, 95% confidence interval −2.66 to −0.95) indicating less severe urinary symptoms than those in the usual care arm. LUTS specific quality of life, incontinence, and perception of LUTS also improved more in the intervention arm than usual care arm at 12 months. The proportion of urology referrals (intervention 7.3%, usual care 7.9%) and adverse events (intervention seven events, usual care eight events) were comparable between the arms. Conclusions A standardised and manualised intervention in primary care showed a sustained reduction in LUTS in men at 12 months. The mean difference of −1.81 points (95% confidence interval −0.95 to −2.66) on the IPSS was less than the predefined target reduction of 2.0 points. Trial registration ISRCTN Registry ISRCTN11669964 .

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Treatment of lower urinary tract symptoms in men in primary care using a conservative intervention: cluster randomised controlled trial

Drake,

Worthington,

Frost

et al. 2023

BMJ

View full text Add to dashboard Cite

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“…Previous studies have identified components of self-management interventions for LUTS in uncomplicated men, such as providing information and education, [23][24][25][26] fluid management, 23,[26][27][28][29] reduced caffeine/ alcohol consumption, [23][24][25][26][27][28] bladder re-training and pelvic floor muscle training, [23][24][25][26][27][28][29] selection of incontinence products, 27 biofeedback, 27 exercise and weight reduction, 23 concurrent medication, 24,26 avoidance of constipation, [24][25][26] and urethral milking. 23,26,27 In this study, we integrated self-management of LUTS in post-total prostatectomy cancer patients and were able to identify 42 subcategories and 10 categories.…”

Section: Discussionmentioning

confidence: 99%

Self‐management of lower urinary tract symptoms in post‐prostatectomy cancer patients: Content analysis

Amano

Suzuki

2022

Int J of Uro Nursing

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What are the experiences of post-prostatectomy cancer patients regarding selfmanagement of lower urinary tract symptoms? Individuals with prostate cancer are required to self-manage their post-operative lower urinary tract symptoms and issues associated with them. Clarifying the various aspects of self-management can help in improving patient-tailored support. This study therefore aimed to clarify the selfmanagement of lower urinary tract symptoms in prostate cancer patients who underwent total prostatectomy. Most post-prostatectomy cancer patients have multiple lower urinary tract symptoms. They have a reduced quality of life due to the symptoms and associated physical, psychological, and social issues. Self-management of the symptoms in uncomplicated cases has been shown to be effective, but this has not been clarified for post-prostatectomy cancer patients. The study setting consisted of two designated cancer centres. A survey with semi-structured interviews was conducted among 13 patients with prostate cancer that underwent total prostatectomy. Data were analysed using the qualitative content analysis techniques of Mayring. A total of 410 codes were extracted from which 42 subcategories and 10 categories emerged. The categories were: (1) recognition of issues associated with lower urinary tract symptoms to be solved; (2) examination of strategies for coping with these symptoms; (3) incorporation of actions that lead to an improvement in the symptoms; (4) avoidance of behaviours that cause worsening of the symptoms;(5) devising ways to prevent interference with one's daily life; (6) dealing with problems associated with the symptoms; (7) building relationships with medical staff and surroundings; (8) self-evaluation of bladder control status; (9) positive acceptance of the symptoms; and (10) sensing the effectiveness of strategies regarding the control of urination. The results suggest that health care professionals need to provide feedback to patients on LUTS strategies and their effects to help support patient coping strategies. In addition, determining individual patients' strengths and deficiencies in self-management will allow us to tailor assistance to patients. This is the first step towards the development of self-management scales to objectively assess selfmanagement.

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<p>What Do Men with Lower Urinary Tract Symptoms Expect from a Urologist in Secondary Care?</p>

Brandenbarg

Rooijers

Steffens

et al. 2020

PPA

Self Cite

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Purpose To identify the expectations of men with LUTS referred to a urologist and to study the association between those expectations and satisfaction with the care provided. Methods In this prospective cohort study, adult men with LUTS completed a questionnaire before their first outpatient appointment, and again at 6 and 12 weeks. The questionnaires included IPSS and OABq-SF, and self-constructed questions on patient expectations, outcome of expectations and satisfaction. Results Data from 182 participants showed positive expectations about the urologist performing examinations, providing explanations and finding the underlying cause, but mostly neutral expectations for treatment plans and outcomes. Positive treatment expectations were associated with positive expectations about outcomes after physiotherapy, drug treatment and surgery. Higher symptom scores and age were associated with higher expectations about drug treatment. Expectations were subjectively and objectively fulfilled for 66.4% and 27.3%, respectively. Symptom improvement (decrease in IPSS scores) was significantly more in men with objectively fulfilled expectations than in men with no unfulfilled expectations. No significant difference was present between men with subjectively fulfilled expectations and men with unfulfilled expectations. However, satisfaction was significantly higher for patients with subjectively fulfilled expectations at 6 and 12 weeks compared with those who had unfulfilled expectations. Conclusion Most men referred to a urologist with LUTS do express clear expectations about treatment in secondary care. Patients with higher expectations for treatment outcomes are more likely to expect to receive that treatment. Satisfaction with the care of a urologist is also higher when patients self-report that they receive the treatment they expected.

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Effectiveness of a newly developed online self‐management program for male patients with uncomplicated lower urinary tract symptoms

Cited by 3 publications

References 14 publications

Treatment of lower urinary tract symptoms in men in primary care using a conservative intervention: cluster randomised controlled trial

Treatment of lower urinary tract symptoms in men in primary care using a conservative intervention: cluster randomised controlled trial

Self‐management of lower urinary tract symptoms in post‐prostatectomy cancer patients: Content analysis

<p>What Do Men with Lower Urinary Tract Symptoms Expect from a Urologist in Secondary Care?</p>

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