Prevention of Urinary Incontinence by Behavioral Modification Program: A Randomized, Controlled Trial Among Older Women in the Community

Diokno, Ananias C.; Sampselle, Carolyn M.; Herzog, A. Regula; Raghunathan, T. E.; Hines, Sandra; Messer, Kassandra L.; Karl, Cindy R.; Leite, Maria Claudia A.

doi:10.1097/01.ju.0000111503.73803.c2

Cited by 99 publications

(62 citation statements)

References 16 publications

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“…The effectiveness and feasibility of a relatively simple preventive intervention for women with no or infrequent incontinence has been shown by Diokno and colleagues. 15 After a 2-hour informational session followed 2 to 4 weeks later by an individualized session, twice as many women remained completely continent or continued to have only infrequent incontinence one year later.…”

Section: Discussionmentioning

confidence: 99%

Population Based Study of Incidence and Predictors of Urinary Incontinence in Black and White Older Adults

et al. 2008

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PURPOSE-To determine incidence and predictors of incident urinary incontinence over 3 years in community-dwelling older adults. MATERIALS & METHODS-A population-based, prospective cohort study was conducted with a random sample of Medicare beneficiaries, stratified to be 50% African American, 50% men, and 50% rural. In-home baseline assessment included standardized questionnaires and short physical performance battery. Three annual follow-up interviews were conducted by telephone. Incontinence was defined as any degree of incontinence occurring at least once a month in the past 6 months.RESULTS-Participants were 490 women and 496 men, age 65 to 106 years (mean=75 years). Prevalence of incontinence at baseline was 41% in women and 27% in men. Three-year incidence of incontinence was 29% (84/290) in women and 24% (86/363) in men. There were no differences by race in prevalent or incident incontinence. In multivariable logistic regression models for women, significant independent baseline predictors of new incontinence included: stroke (OR 3.4, p=.011), incontinence < monthly (OR 3.3, p=.001), past or current post-menopausal estrogen (OR 2.3, p<.006), slower time to stand from a chair 5 times (OR 1.3, p<.045), and higher Geriatric Depression Scale Score (OR 1.2, p=.016). For men, significant independent baseline predictors of new incontinence included: incontinence < monthly (OR 4.2, p<.001) and lower score on the composite Physical Performance Score (OR 1.2, p<.001).CONCLUSIONS-Prevalence of incontinence among community-dwelling older adults was high with an additional 29% of women and 24% of men reporting incident incontinence over 3 years of follow-up. Infrequent incontinence is a strong risk factor for developing at least monthly incontinence in both men and women.

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Section: Discussionmentioning

confidence: 99%

Population Based Study of Incidence and Predictors of Urinary Incontinence in Black and White Older Adults

et al. 2008

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“…At the 12-month data point 68% reported practice of PFMT at least 2-3 times a week. Due to the limitations of self-reported behaviors, we looked to the objective outcome measures from the RCT [3] to validate the BT and PFMT self-reports. Using data from 3-day voiding diaries at exit from the RCT after 12 months, voiding frequencies on three parameters (24 h, while asleep, while awake) showed significant reductions in the treatment group (p<0.0001).…”

Section: Resultsmentioning

confidence: 99%

“…Greater knowledge of the rationale and methods for BT and PFMT, in conjunction with effective motor skill for the performance of PFMT, will benefit the continence status of women [3]. Because sustaining the behavioral change is essential to the success of behavioral intervention, it is noteworthy that the BMP was effective in motivating a 68% PFMT adherence rate, i.e., practicing 2-3 times per week (32%) or at least once a day (36%) and a 58% BT (Table 4) adherence or within recommended interval at 12 months post-intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Although the efficacy of PFMT for prevention of UI has been shown with pregnant and postpartum women [16][17][18], our recently reported randomized controlled trial (RCT) was the first to our knowledge to demonstrate the preventive capacity of combined PFMT and BT in older women [3]. The rationale for that test of prevention was rooted in the expectation that these efficacious behavioral therapies would also decrease women's risk of developing UI.…”

Section: Introductionmentioning

confidence: 99%

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Learning outcomes of a group behavioral modification program to prevent urinary incontinence

et al. 2005

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This study describes acquisition of knowledge and motor skill in bladder training (BT) and pelvic floor muscle training (PFMT) and adherence following a behavioral modification program (BMP). Essentially continent (0-5 episodes in past year) community-dwelling older women (n = 359) were randomized to treatment (n = 164), a 2-h group education session supplemented by one brief individualized session of approximately 10 min, or control (n = 195), no instruction, and followed for 12 months. Knowledge, motor skill, and adherence to the BMP were documented. Changes in pelvic muscle function and voiding interval were used to validate self-reported adherence. Following group instruction, mean BT and PFMT knowledge was 90 and 86%, respectively; 68% demonstrated correct PFMT technique without additional instruction, 29% required brief instruction, and 3% were unable to learn PFMT technique. Adherence ranged from 63 to 82% for PFMT and 58 to 67% for BT. Group instruction supplemented with brief individual instruction as needed is an effective teaching method for BT and PFMT.

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“…In the Control arm, continent women were observed, and provided with the behavioral modification program at the end of the 1-year trial period. The behavioral program and results of the clinical trial are described elsewhere [21].…”

Section: Design Of Mesa Prevention Trialmentioning

confidence: 99%

Evaluation of a mass mailing recruitment strategy to obtain a community sample of women for a clinical trial of an incontinence prevention intervention

et al. 2006

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Prevention of Urinary Incontinence by Behavioral Modification Program: A Randomized, Controlled Trial Among Older Women in the Community

Abstract: To our knowledge we report the first randomized, controlled trial of BMP for preventing urinary incontinence in older women. It demonstrated feasibility and efficacy in improving continence status, pelvic muscle strength and voiding control as long as a year after treatment.

Cited by 99 publications

References 16 publications

Population Based Study of Incidence and Predictors of Urinary Incontinence in Black and White Older Adults

Population Based Study of Incidence and Predictors of Urinary Incontinence in Black and White Older Adults

Learning outcomes of a group behavioral modification program to prevent urinary incontinence

Evaluation of a mass mailing recruitment strategy to obtain a community sample of women for a clinical trial of an incontinence prevention intervention

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