Division Health Economics, Health Policy and Outcomes Research, Centre for Social Policy Research, University of Bremen, Bremen, Germany.
Neurourol Urodyn. 2012 Jan;31(1):93-8. doi: 10.1002/nau.21177. Epub 2011 Jul 20.
Objectives of this study were to examine the administrative incidence of urinary incontinence in children and to assess related outpatient health services utilization in this cohort.
Data of a statutory health insurance company were analyzed and outpatients from 1 to 18 years of age with a first recorded ICD-10 code for non-organic urinary incontinence during a 1-year-period (2007) were identified. For this cohort, the prescription of desmopressin, antispasmodics, non-selective monoamine reuptake inhibitors, alarm devices, and incontinence pads in the quarter of the first diagnosis and in the following one (i.e., 6 months) was evaluated with respect to age and gender.
3,188 patients (59.4% male; mean age 6.8 years) matched the inclusion criteria, of whom 25.4% were under 5 years old. 7.9% were prescribed desmopressin, 7.4% received urinary antispasmodics, and 7.0% were treated with alarm devices. For 77.9% of patients, no specific incontinence-related treatments were prescribed. We found considerable differences in treatment patterns between age groups, with patients ≥ 7 years receiving desmopressin more frequently than alarm devices. Regarding gender differences, the proportion of males treated with alarm devices (prevalence ratio [PR] 1.46; 95% confidence interval [95%CI] 1.11-1.92) and at least one specific treatment (PR 1.19; 95%CI 1.04-1.35) remained statistically significantly higher, even after adjusting for age.
In our study, we found evidence that treatment modalities only partly comply with the current guidelines for treatment of children and adolescents with non-organic urinary incontinence. Therefore, the dissemination of current guidelines remains a major educational goal.
本研究旨在调查儿童尿失禁的管理发病率，并评估该队列中相关门诊卫生服务的利用情况。
对一家法定健康保险公司的数据进行分析，确定在 1 年（2007 年）期间，首次记录 ICD-10 非器质性尿失禁编码的 1 至 18 岁门诊患者。对于该队列，根据年龄和性别评估首次诊断季度和随后一个季度（即 6 个月）的去氨加压素、抗痉挛药物、非选择性单胺再摄取抑制剂、报警装置和失禁垫的处方情况。
3188 例患者（59.4%为男性；平均年龄 6.8 岁）符合纳入标准，其中 25.4%的患者年龄小于 5 岁。7.9%的患者开具去氨加压素，7.4%的患者接受了尿抗痉挛药物治疗，7.0%的患者使用了报警装置。对于 77.9%的患者，没有开具特定的尿失禁相关治疗药物。我们发现，不同年龄组的治疗模式存在显著差异，≥7 岁的患者开具去氨加压素的频率高于报警装置。关于性别差异，使用报警装置（优势比 [PR] 1.46；95%置信区间 [95%CI] 1.11-1.92）和至少一种特定治疗（PR 1.19；95%CI 1.04-1.35）的男性比例仍然具有统计学意义，即使在调整年龄后也是如此。
在本研究中，我们发现治疗方式仅部分符合当前治疗非器质性儿童和青少年尿失禁的指南。因此，传播当前指南仍然是一个主要的教育目标。
