AUA 2017: Is a Group Learning Behavioral Modification Program Effective and Safe in Reducing Geriatric Urinary Incontinence? A Multi-Center Randomized Controlled Trial
Women were excluded for pelvic organ prolapse, pelvic cancers, bladder surgery. They also had to be naïve to any OAB treatments including drug therapy and/or behavioral treatment. The GBT group attended a 2-hr class of information on bladder health and self-management that included education on anatomy & physiology basis for continence, pelvic floor muscle (PFM) identification and training with knack/stress strategy, bladder training/urge suppression strategies and left the class with an informational brochure. The control group only received the brochure and at the end of the 12-month study were offered referral to specialist or the 2-hr class. Primary outcome was the ICIQ-UI SF. Secondary outcomes included 3 day voiding diary (VD); 24hr pad weighing; provocative cough stress test; PGII, IQOL, and the Brink PFM strength test. Evaluators were blinded to participant’s assignment. Data was collected five times over a 12 months period. 463 women were randomized (GBT=232; Control=231), 34 (7.3%) withdrew. There were no difference between the control and GBT groups for the following variables: age, race, education, and income, living with a partner, BMI, medical & surgical histories. Results were impressive as there was no significant differences in both primary and secondary outcomes between the two groups seen at 3, 6, 9 & 12 months favored the GBT group except there was no significant increase in the Brink PFM strength in either group. Significant improvement in favor of GBT over Control occurred in: # of leaks on 3-day voiding dairy (p 0.0002), 24-hr pad weight test (p 0.0007), provocative cough stress test (p 0.0008), MESA questionnaire score (p<0.0001), Incontinence QOL (p<0.0001), and the Patient Global Impression-Improvement (p<0.0001). This GBT bladder health education program was safe and effective in reducing UI frequency, severity & bother, improving QOL for older women in the community regardless of lack of PFM strength improvement. Intervention has the opportunity to reach larger populations.
Presented by: Ananias Diokno, Lisa Low, Diane Newman & The GLADIOLUS Research Team
Written by: Diane K. Newman, DNP, FAAN, BCB-PMD, Perelman School of Medicine, University of Pennsylvania
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA