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健康教育干预对膀胱过度活动症患者的影响。

Impact of a health education intervention in overactive bladder patients.

作者信息

Herschorn Sender, Becker Debbie, Miller Elizabeth, Thompson Melissa, Forte Lindy

机构信息

Sunnybrook Health and Women's College Health Sciences Centre, Toronto, Ontario, Canada.

出版信息

Can J Urol. 2004 Dec;11(6):2430-7.

Abstract

OBJECTIVE

To assess a standardized and simple educational intervention in overactive bladder (OAB) patients to improve compliance with anticholinergic medication, increase the use of concomitant behavioral treatments, and improve patients' perception of bladder symptoms.

MATERIALS AND METHODS

This is a 16-week open-label randomized trial of tolterodine combined with an education intervention for the experimental group versus tolterodine alone (no intervention) for the control group. The setting was in family medicine and urology clinics in Ontario. The participants were male and female adults with OAB symptoms. Both groups received tolterodine prescriptions. The intervention patients received printed information and an explanation about OAB, medication use, and behavioral treatments (kegel exercise, bladder stretching, fluid regulation). The primary outcomes were medication compliance and persistence at 16 weeks. Secondary outcomes were use of behavioral treatments and self-reported severity of symptoms.

RESULTS

More patients in the intervention group (experimental) purchased their prescriptions (p<0.05). Compliance rate was greater for the intervention group (39%), versus the control group (31%) at 16 weeks although the difference was not significant (p>0.05). Significantly more patients started and/or continued non-drug treatments in the intervention group (82%) compared to the control group (53%) (p<0.05). Furthermore, more patients in this group reported improvement in severity of bladder symptoms (p<0.05).

CONCLUSIONS

The simple education intervention resulted in a greater, but not significant, increase in compliance with medication compared to the control group. It also resulted in a significantly increased use of behavior modification therapies and better self-perception of treatment outcome.

摘要

目的

评估一种标准化且简单的教育干预措施,用于改善膀胱过度活动症(OAB)患者对抗胆碱能药物的依从性,增加辅助行为治疗的使用,并改善患者对膀胱症状的认知。

材料与方法

这是一项为期16周的开放标签随机试验,试验组使用托特罗定并联合教育干预措施,对照组仅使用托特罗定(无干预)。研究地点为安大略省的家庭医学和泌尿外科诊所。参与者为有OAB症状的成年男女。两组均开具了托特罗定处方。干预组患者收到了关于OAB、药物使用和行为治疗(凯格尔运动、膀胱伸展、液体调节)的印刷信息及解释。主要结局指标为16周时的药物依从性和持续性。次要结局指标为行为治疗的使用情况和自我报告的症状严重程度。

结果

干预组(试验组)中购买处方的患者更多(p<0.05)。16周时,干预组的依从率为39%,高于对照组的31%,尽管差异不显著(p>0.05)。与对照组(53%)相比,干预组中开始和/或持续进行非药物治疗的患者显著更多(82%)(p<0.05)。此外,该组中更多患者报告膀胱症状严重程度有所改善(p<0.05)。

结论

与对照组相比,简单的教育干预使药物依从性有更大但不显著的提高。它还导致行为矫正疗法的使用显著增加,以及对治疗效果有更好的自我认知。

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