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Group Learning Achieves Decreased Incidents of Lower Urinary Symptoms

小组学习减少了下尿路症状的发生率

基本信息

批准号：
8578633
负责人：
KATHRYN Larsen BURGIO
金额：
$ 143.76万
依托单位：
WILLIAM BEAUMONT HOSPITAL RESEARCH INST
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-01 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8578633
关键词：
Address Award Behavior Therapy Bladder Client satisfaction Clinical effectiveness Consultations Data Data Coordinating Center Economic Burden Effectiveness Evaluation Frequencies Grant Guidelines Health Health Personnel Healthcare Systems Hour Human Incontinence Individual Instruction International Intervention Learning Living Costs Measures Medical Modality Modeling Muscle Contraction Outcome Outcome Measure Participant Patient Self-Report Patients Pelvic Floor Muscle Perception Pilot Projects Population Quality of life Questionnaires Randomized Randomized Controlled Trials Recruitment Activity Research Research Personnel Savings Schedule Self Management Severities Site Stress Stress Urinary Incontinence Symptoms Testing Therapeutic Time Training Urinary Incontinence Urine Visit Woman arm base care delivery clinical research site community setting compare effectiveness cost cost effective cost effectiveness economic cost evidence based guidelines health care cost/financing interest micturition urgency muscle strength novel older women prevent primary outcome secondary outcome social treatment program urinary

项目摘要

DESCRIPTION (provided by applicant): Urinary Incontinence (UI) is a prevalent condition that diminishes quality of life in older women at tremendous social and economic costs. Although there are several therapeutic options available, behavioral treatments are recommended by most evidence-based guidelines as an initial approach to treatment for stress, urgency, and mixed UI. Behavioral treatments are usually delivered in individualized visits in medical offices, but a group session model of care delivery has been shown to be effective. Based on promising outcomes in our pilot studies using a novel group treatment approach, we were awarded a planning grant to assemble an interdisciplinary team of experts and develop a multi-center randomized controlled trial (RCT). The proposed study is a three-site RCT to compare the effectiveness and cost-effectiveness of a group-administered behavioral treatment program to no treatment. Women with stress, urgency, or mixed UI will be recruited and screened centrally, evaluated clinically at each of three study sites, and randomly assigned to one of two treatment arms: 1) Group behavioral treatment (GBT) or 2) No treatment. Outcomes will be assessed at 3-, 6-, 9-, and 12-months post-randomization. The primary outcome will be self- reported UI severity as measured by the International Consultation on Incontinence Questionnaire-UI Short Form (ICI-Q), a validated measure for research and practice. Secondary outcome measures will assess frequency of incontinence episodes, volume of urine loss, type of incontinence, pelvic floor muscle strength, patient satisfaction, patient perception of improvement, impact on quality of life, and cost-effectiveness. Once standardized with data to support its clinical effectiveness and cost-effectiveness, group treatment modalities have potential to reach a larger population of older women with UI, not only in traditional medical settings, but also in community settings, significantly reducing the human and economic burden of UI on patients, health care providers, and the health care system as a whole. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page

描述（由申请人提供）：尿失禁（UI）是一种普遍的疾病，它降低了老年妇女的生活质量，造成了巨大的社会和经济成本。虽然有几种治疗方法可供选择，但大多数循证指南建议将行为治疗作为治疗压力、急迫性和混合性尿失尿的初始方法。行为治疗通常是在医疗办公室的个性化访问中提供的，但一种小组会议模式的护理交付已被证明是有效的。基于我们使用一种新颖的群体治疗方法进行的试点研究的良好结果，我们获得了一笔计划拨款，以组建一个跨学科的专家团队，并开展一项多中心随机对照试验（RCT）。这项提议的研究是一项三点随机对照试验，以比较群体管理的行为治疗方案与不治疗的有效性和成本效益。有压力性、急迫性或混合性尿失禁的妇女将被招募并集中筛选，在三个研究地点进行临床评估，并随机分配到两个治疗组中的一个：1)群体行为治疗（GBT）或2)不治疗。结果将在随机化后3、6、9和12个月进行评估。主要结果将是自我报告的尿失禁严重程度，由失禁国际咨询问卷-尿失禁简短表格（ICI-Q）衡量，这是一项研究和实践的有效措施。次要结局指标将评估失禁发作的频率、尿失量、失禁类型、骨盆底肌肉力量、患者满意度、患者对改善的感知、对生活质量的影响和成本效益。一旦用支持其临床效果和成本效益的数据进行标准化，群体治疗模式就有可能覆盖更多患有尿失尿的老年妇女，不仅在传统医疗环境中，而且在社区环境中，显著减轻尿失尿对患者、卫生保健提供者和整个卫生保健系统的人力和经济负担。小灵通398/2590 （Rev. 06/09）页延续格式页