OBJECTIVES: The objectives of this study were to assess the effectiveness and cost-effectiveness of different types of absorbent product for people with incontinence. DESIGN: A systematic review of randomized and quasi-randomized controlled trials was performed to compare different types of absorbent products for the containment of urinary and/or fecal incontinence in adults. SETTING AND METHODS: Randomized and quasi-randomized trials available by March 2000 were used. Trials were identified through searches of major bibliographic and research databases. Investigators in the field were also contacted to locate studies. SUBJECTS: The trials reviewed comprised a total of 345 participants. RESULTS: Five trials were identified. The following comparisons were considered: disposable versus nondisposable pad-and-pant systems or all-in-one diapers (bodyworns), disposable versus nondisposable underpads, bodyworns versus underpads, and superabsorbent versus fluff-pulp products. Outcomes and type of intervention were heterogeneous among trials. Combining data from more than one trial proved to be impracticable. In a single trial, fewer people who used disposable products complained of skin problems compared with those who used nondisposable products (odds ratio, 0.08; 95% confidence interval 0.03 to 0.20). Similarly, people who used superabsorbent products experienced less severe skin problems than those who used fluff pulp products (P <.03). CONCLUSIONS: The data were too few and of insufficient quality to provide a firm basis for practice. However, the data suggest that disposable products are more costly but more effective than nondisposable products in decreasing the incidence of skin problems and that superabsorbent products perform better than fluff pulp products.
OBJECTIVES: The objectives of this study were to assess the effectiveness and cost-effectiveness of different types of absorbent product for people with incontinence. DESIGN: A systematic review of randomized and quasi-randomized controlled trials was performed to compare different types of absorbent products for the containment of urinary and/or fecal incontinence in adults. SETTING AND METHODS: Randomized and quasi-randomized trials available by March 2000 were used. Trials were identified through searches of major bibliographic and research databases. Investigators in the field were also contacted to locate studies. SUBJECTS: The trials reviewed comprised a total of 345 participants. RESULTS: Five trials were identified. The following comparisons were considered: disposable versus nondisposable pad-and-pant systems or all-in-one diapers (bodyworns), disposable versus nondisposable underpads, bodyworns versus underpads, and superabsorbent versus fluff-pulp products. Outcomes and type of intervention were heterogeneous among trials. Combining data from more than one trial proved to be impracticable. In a single trial, fewer people who used disposable products complained of skin problems compared with those who used nondisposable products (odds ratio, 0.08; 95% confidence interval 0.03 to 0.20). Similarly, people who used superabsorbent products experienced less severe skin problems than those who used fluff pulp products (P <.03). CONCLUSIONS: The data were too few and of insufficient quality to provide a firm basis for practice. However, the data suggest that disposable products are more costly but more effective than nondisposable products in decreasing the incidence of skin problems and that superabsorbent products perform better than fluff pulp products.