Urinary Problems in Women

French, Linda M.; Phelps, Kevin; Pothula, Dr. Nageswar Rao; Mushkbar, Saudia

doi:10.1016/j.pop.2008.10.003

Cited by 7 publications

(5 citation statements)

References 95 publications

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“…Inappropriate drug use may increase the risk of the occurrence and persistence of geriatric problems [3, 5, 6, 9–15]. The most common major impairments that appear in older people, also referred to as “geriatric giants” are immobility, instability, including falls and dizziness, incontinence and cognitive impairment [16].…”

Section: Introductionmentioning

confidence: 99%

Opti-Med: the effectiveness of optimised clinical medication reviews in older people with ‘geriatric giants’ in general practice; study protocol of a cluster randomised controlled trial

et al. 2014

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BackgroundInappropriate drug use has been identified as one of the most important problems affecting the quality of care in older people. Inappropriate drug use may increase the risk of the occurrence of ‘geriatric giants’ such as immobility, instability, incontinence and cognitive impairment. There are indications that clinical medication reviews (CMR) can reduce inappropriate drug use. However, CMRs have not yet been implemented at a large scale in primary care. An innovative medication review program in primary care will be developed which tackles the most important obstacles for a large scale implementation of CMRs. The aim of this study is to assess whether this CMR program is (cost-) effective compared with usual general practice care for older patients with geriatric symptoms with regard to quality of life and geriatric symptoms.MethodsA cluster randomised controlled trial will be performed in 20 Dutch general practices including 500 patients. Patients of 65 years and older are eligible if they newly present with pre-specified geriatric symptoms in general practice and chronic use of at least one prescribed drug. GP practices will be stratified by practice size and randomly allocated to control (n = 10) or intervention group (n = 10). The intervention consists of CMRs which will be facilitated and prepared by an expert team consisting of a GP and a pharmacist. Primary outcome measures are patient’s quality of life and the presence of self-reported geriatric symptoms during a follow-up period of 6 months. Secondary outcomes are costs of healthcare utilisation, feasibility, number of drug related problems, medication adherence and satisfaction with medication.DiscussionThis study is expected to add evidence on the (cost-) effectiveness of an optimally facilitated, prepared and structured CMR in comparison with usual care in older patients who present a geriatric symptom to their GP. The strength of this study is that it will be conducted in daily clinical practice. This improves the possibilities to implement the CMRs in the primary care setting on a large scale.Trial registrationNetherlands Trial register: NTR4264Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2318-14-116) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Opti-Med: the effectiveness of optimised clinical medication reviews in older people with ‘geriatric giants’ in general practice; study protocol of a cluster randomised controlled trial

et al. 2014

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“…Furthermore, although a bacterial culture of > 100,000 colony-forming units (CFU)/mL is generally accepted as defining an infection of the urinary tract, many authors describe the same symptoms in patients with lower levels of bacteriuria and even in culture-negative women. [4][5][6][7] It has even been suggested that antibiotic therapy was effective in culture-negative women. 8 These conflicting observations demonstrate that much is unclear about the clinical evolution of signs and symptoms in women with suspected cystitis who are receiving antimicrobial treatment.…”

mentioning

confidence: 99%

Cystitis: Symptomatology in Women with Suspected Uncomplicated Urinary Tract Infection

Heytens

Sutter

Backer

et al. 2011

Journal of Women's Health

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Background: Although cystitis in women is very common in general practice, its evolution in symptoms has not been clearly studied. Qualitative research has pointed to other than the classic symptomatology. Methods: This was a prospective observational study of the symptomatology at presentation and the evolution of the symptoms in treated women with suspected uncomplicated urinary tract infection (UTI). Women consulting their general practitioner (GP) for dysuria, urgency, or frequency produced a urine sample (for bacteriologic processing) and kept a diary until the end of the symptoms. Exclusion criteria included complaints > 1 week, fever, vaginal discharge, and known pathology. Results: Of the 300 asked to participate, 148 (49%) returned the diary. Although none of the patients developed acute pyelonephritis, a substantial number of the women had such complaints as feeling feverish (33% in culture-positive group, 38% in culture-negative group), back pains (44% vs. 56%), and feeling weak and tired (71% vs. 65%). Differences between the culture-positive and culture-negative groups were not statistically significant except for the duration of symptoms, which was shorter in the culture-positive group (4 vs. 6 days). More severe symptoms at inclusion were correlated with a longer duration of these symptoms. Conclusions: The spectrum of complaints in women with suspected uncomplicated UTI is broad and comprises a number of symptoms usually associated with an upper UTI. The occurrence of these symptoms should not automatically prompt GPs to prescribe broad-spectrum antibiotics. Moreover, the duration of symptoms exceeding the recommended duration of antibiotic therapy does not indicate therapy failure and, thus, the need for changing antibiotic therapy.

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“…LUTS may be caused by a number of conditions that originate within the lower urinary tract, including involuntary bladder contractions, bladder outlet obstruction, benign prostatic enlargement, interstitial cystitis/bladder pain syndrome, urinary tract infection, pelvic organ prolapse, bladder cancer, conditions secondary to trauma (e.g. neurological damage, complications during pregnancy and delivery) and others (11–16). However, LUTS also may be related to comorbidities outside the lower urinary tract and to behavioural and physical factors, including diet, medication use and toileting behaviours (17–19).…”

Section: Introductionmentioning

confidence: 99%