Document Detail


Adherence to behavioral interventions for urge incontinence when combined with drug therapy: adherence rates, barriers, and predictors.
MedLine Citation:
PMID:  20671098     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Behavioral intervention outcomes for urinary incontinence (UI) depend on active patient participation.
OBJECTIVE: The purpose of this study was to describe adherence to behavioral interventions (pelvic-floor muscle [PFM] exercises, UI prevention strategies, and delayed voiding), patient-perceived exercise barriers, and predictors of exercise adherence in women with urge-predominant UI.
DESIGN: This was a prospectively planned secondary data analysis from a 2-stage, multicenter, randomized clinical trial.
PATIENTS AND INTERVENTION: Three hundred seven women with urge-predominant UI were randomly assigned to receive either 10 weeks of drug therapy only or 10 weeks of drug therapy combined with a behavioral intervention for UI. One hundred fifty-four participants who received the combined intervention were included in this analysis.
MEASUREMENTS: Pelvic-floor muscle exercise adherence and exercise barriers were assessed during the intervention phase and 1 year afterward. Adherence to UI prevention strategies and delayed voiding were assessed during the intervention only.
RESULTS: During intervention, 81% of women exercised at least 5 to 6 days per week, and 87% performed at least 30 PFM contractions per day. Ninety-two percent of the women used the urge suppression strategy successfully. At the 12-month follow-up, only 32% of the women exercised at least 5 to 6 days per week, and 56% performed 15 or more PFM contractions on the days they exercised. The most persistent PFM exercise barriers were difficulty remembering to exercise and finding time to exercise. Similarly, difficulty finding time to exercise persisted as a predictor of PFM exercise adherence over time.
LIMITATIONS: Co-administration of medication for UI may have influenced adherence.
CONCLUSIONS: Most women adhered to exercise during supervised intervention; however, adherence declined over the long term. Interventions to help women remember to exercise and to integrate PFM exercises and UI prevention strategies into daily life may be useful to promote long-term adherence.
Authors:
Diane Borello-France; Kathryn L Burgio; Patricia S Goode; Alayne D Markland; Kimberly Kenton; Aarthi Balasubramanyam; Anne M Stoddard;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-07-29
Journal Detail:
Title:  Physical therapy     Volume:  90     ISSN:  1538-6724     ISO Abbreviation:  Phys Ther     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2010-10-29     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0022623     Medline TA:  Phys Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1493-505     Citation Subset:  AIM; IM    
Affiliation:
Department of Physical Therapy, Duquesne University, 111 Health Sciences Bldg, Pittsburgh, PA 15282, USA. borellofrance@duq.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00090584
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MeSH Terms
Descriptor/Qualifier:
Adult
Behavior Therapy / methods*
Combined Modality Therapy
Female
Humans
Intervention Studies
Muscle Contraction / physiology
Patient Compliance*
Pelvic Floor / physiopathology
Physical Therapy Modalities*
Prospective Studies
Questionnaires
Regression Analysis
Treatment Outcome
United States
Urinary Incontinence / drug therapy*,  physiopathology,  rehabilitation*
Grant Support
ID/Acronym/Agency:
U01 DK 58225/DK/NIDDK NIH HHS; U01 DK060380/DK/NIDDK NIH HHS; U01 DK58229/DK/NIDDK NIH HHS; U01 DK58231/DK/NIDDK NIH HHS; U01 DK58234/DK/NIDDK NIH HHS; U01 DK60379/DK/NIDDK NIH HHS; U01 DK60380/DK/NIDDK NIH HHS; U01 DK60393/DK/NIDDK NIH HHS; U01 DK60395/DK/NIDDK NIH HHS; U01 DK60397/DK/NIDDK NIH HHS; U01 DK60401/DK/NIDDK NIH HHS
Investigator
Investigator/Affiliation:
William Steers / ; Ananias Diokno / ; Veronica Mallett / ; Salil Khandwala / ; Linda Brubaker / ; MaryPat FitzGerald / ; Holly E Richter / ; L Keith Lloyd / ; Michael Albo / ; Charles Nager / ; Toby C Chai / ; Harry W Johnson / ; Halina M Zyczynski / ; Wendy Leng / ; Philippe Zimmern / ; Gary Lemack / ; Stephen Kraus / ; Thomas Rozanski / ; Peggy Norton / ; Lindsey Kerr / ; Sharon Tennstedt / ; Anne Stoddard / ; Debuene Chang / ; John W Kusek / ; Leroy M Nyberg / ; Anne M Weber / ; Diane Borello-France / ; Kathryn L Burgio / ; Seine Chiang / ; Ash Dabbous / ; Chiara Ghetti / ; Patricia S Goode / ; Lee N Hammontree / ; Kimberly Kenton / ; Jerry Lowder / ; Karl Luber / ; Emily Lukacz / ; Alayne Markland / ; Shawn Menefee / ; Pamela Moalli / ; Kenneth Peters / ; Joseph Schaffer / ; Amanda Simsiman / ; Larry Sirls / ; Robert Starr / ; R Edward Varner / ; Rosemary Bradt / ; Laura Burr / ; Karen Debes / ; Tamara Dickinson / ; Rosanna Dinh / ; Judy Gruss / ; Alice Howell / ; Kathy Jesse / ; D Lynn Kalinoski / ; Kristen Mangus / ; Karen Mislanovich / ; Judy Murray / ; Shelly O'Meara / ; Janese Parent / ; Norma Pope / ; Caren Prather / ; Sylvia Sluder / ; Mary Tulke / ; Robin Willingham / ; Gisselle Zazueta-Damian / ; Dorothy Atkins / ; Jan Baker / ; Karen Debes / ; Kathy Jesse / ; Ryanne R Johnson / ; R Jeannine McCormick / ; Karen Mislanovich / ; Christy Moore / ; Elva Kelly Moore / ; Amy Mutch / ; Betsy Nielsen-Omeis / ; Lisa Radebaugh / ; Patsy Riley / ; Karen VandeVegt / ; Kimberly J Dandreo / ; Corinne J Leifer / ; Heather Litman / ; Susan M McDermott / ; Anne M Stoddard / ; Sharon Tennstedt / ; Liane Tinsley / ; Yan Xu / ; Elizabeth A Gormley / ; Paul Abrams / ; Diedre Bland / ; J Quentin Clemens / ; John Connett / ; William Henderson / ; Dee Fenner / ; Sheryl Kelsey / ; Deborah Myers / ; Jacek Mostwin / ; Bassem Wadie /
Comments/Corrections
Comment In:
Phys Ther. 2010 Oct;90(10):1505-7; author reply 1507-9   [PMID:  20889929 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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