A Wagg1, J Duckett, D McClurg, D Harari, D Lowe. 1. Division of Geriatric Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada. adrian.wagg@ualberta.ca
Abstract
UNLABELLED: OBJECTIVE To assess the degree of adherence to the current National Institute for Health and Clinical Excellence (NICE) guidelines on the management of urinary incontinence (UI) in women. DESIGN: Retrospective survey of consecutive female inpatients and outpatients with UI as part of a national audit. SETTING: NHS hospital and primary care (PC) trusts. POPULATION OR SAMPLE: Twenty-five women <65 years old and 25 women ≥ 65 years old from each participating site. METHOD: All NHS trusts in England, Wales and Northern Ireland were eligible to participate. A web-based data collection form aligned to the NICE guidelines was constructed for the study. All data submitted to the audit were anonymous and access to the web-tool was password-protected for confidentiality. RESULTS: Data were returned by 128 acute and 75 PC trusts on 7846 women. No diagnosis was documented in 6.8% (153/2254) of younger and 28% (571/2011) of older women in hospitals (P < 0.001), and by 8.6% (123/1435) of younger and 21% (380/1786) of older women in PC trusts. In hospitals, 26% (396/1524) of younger women and 15% (182/1231) of older women (P < 0.001) and in PC trusts 8.2% (77/934) of younger and 4.7% (46/975) of older women underwent multichannel cystometry before conservative therapy. Documentation of discussion of causes and treatment of UI occurred in 76% (1717/2254) of younger and 44% (884/2011) of older women in hospitals (P < 0.001) and in 75% (1080/1435) of younger and 53% (948/1786) of older women in PC trusts (P < 0.001). CONCLUSION Older women are less likely to receive NICE compliant management. Adherence varies according to recommendation. There needs to be concentration on evidence-based community provision of care by competent and interested clinicians before the aims of the NICE guidelines are met.
UNLABELLED: OBJECTIVE To assess the degree of adherence to the current National Institute for Health and Clinical Excellence (NICE) guidelines on the management of urinary incontinence (UI) in women. DESIGN: Retrospective survey of consecutive female inpatients and outpatients with UI as part of a national audit. SETTING: NHS hospital and primary care (PC) trusts. POPULATION OR SAMPLE: Twenty-five women <65 years old and 25 women ≥ 65 years old from each participating site. METHOD: All NHS trusts in England, Wales and Northern Ireland were eligible to participate. A web-based data collection form aligned to the NICE guidelines was constructed for the study. All data submitted to the audit were anonymous and access to the web-tool was password-protected for confidentiality. RESULTS: Data were returned by 128 acute and 75 PC trusts on 7846 women. No diagnosis was documented in 6.8% (153/2254) of younger and 28% (571/2011) of older women in hospitals (P < 0.001), and by 8.6% (123/1435) of younger and 21% (380/1786) of older women in PC trusts. In hospitals, 26% (396/1524) of younger women and 15% (182/1231) of older women (P < 0.001) and in PC trusts 8.2% (77/934) of younger and 4.7% (46/975) of older women underwent multichannel cystometry before conservative therapy. Documentation of discussion of causes and treatment of UI occurred in 76% (1717/2254) of younger and 44% (884/2011) of older women in hospitals (P < 0.001) and in 75% (1080/1435) of younger and 53% (948/1786) of older women in PC trusts (P < 0.001). CONCLUSION Older women are less likely to receive NICE compliant management. Adherence varies according to recommendation. There needs to be concentration on evidence-based community provision of care by competent and interested clinicians before the aims of the NICE guidelines are met.
Authors: K M Holtzer-Goor; J G Gaultney; P van Houten; A S Wagg; S A Huygens; M M J Nielen; C P Albers-Heitner; W K Redekop; M P Rutten-van Mölken; M J Al Journal: PLoS One Date: 2015-10-01 Impact factor: 3.240