Department General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands.
Department General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
BMJ Open. 2022 Sep 6;12(9):e059654. doi: 10.1136/bmjopen-2021-059654.
To improve continence care in the Netherlands, a new framework has been developed in which a shift has been made from incontinence severity as the sole criterion for selecting incontinence products to a focus on patient need for daily life activities. The impact of the framework on daily care has not been assessed. We aimed to compare treatment effectiveness and costs between participants who did and did not undergo re-evaluation according to the new framework.
Cohort study SETTING: Twelve pharmacies in the Netherlands PARTICIPANTS: Existing users of absorbent incontinence materials for urinary incontinence.
Participants were offered the option to have their incontinence products re-evaluated within the new framework at their pharmacy.
Effectiveness and cost outcomes were assessed at 3 and 6 months through questionnaires. These questionnaires included the International Consultation on Incontinence Questionnaire (ICIQ) Lower Urinary Tract Symptoms Quality of Life Module, ICIQ Urinary Incontinence Short Form, ICIQ Absorbent Pads, questions about satisfaction and the iPCQ and iMCQ.
303 users consented and 279 completed the baseline questionnaire. Of these participants, 72 agreed to a re-evaluation of their incontinence materials. There was a small improvement at 3 months in the re-evaluation group compared with the other group on most outcomes. However, these improvements were not clinically relevant. Moreover, these differences did not change much from 3 to 6 months. Small differences were also observed in the changes in costs, but with very wide CIs on both sides of zero (€99.38; 95% CI -633.48 to 832.23).
The current study showed no clinically relevant effect of a newly implemented framework for selecting incontinence materials in pharmacies when compared with an existing method. Given that the study also showed no differences in effectiveness and costs, introducing the new framework in pharmacies may not lead to better incontinence care.
为了改善荷兰的控尿护理，我们制定了一个新的框架，将选择失禁产品的标准从单纯的失禁严重程度转移到患者对日常生活活动的需求上。该框架对日常护理的影响尚未得到评估。我们旨在比较根据新框架进行重新评估的参与者和未进行重新评估的参与者的治疗效果和成本。
队列研究
荷兰的 12 家药店
患有尿失禁的现有吸收性失禁材料使用者。
参与者可选择在他们的药店根据新框架重新评估他们的失禁产品。
通过问卷在 3 个月和 6 个月时评估效果和成本结果。这些问卷包括国际尿失禁咨询问卷（ICIQ）下尿路症状生活质量模块、ICIQ 尿失禁简短问卷、ICIQ 吸收垫、关于满意度的问题以及 iPCQ 和 iMCQ。
303 名使用者同意并完成了基线问卷。在这些参与者中，72 人同意重新评估他们的失禁材料。与其他组相比，重新评估组在大多数结果上在 3 个月时有较小的改善。然而，这些改善并不具有临床意义。此外，这些差异从 3 个月到 6 个月变化不大。在成本变化方面也观察到较小的差异，但置信区间（CI）非常宽（99.38 欧元；95%CI-633.48 至 832.23）。
与现有方法相比，当在药店中选择失禁材料时，当前研究表明新实施的框架没有临床相关效果。鉴于该研究在效果和成本方面也没有差异，在药店中引入新框架可能不会导致更好的控尿护理。
