Adherence to Behavioral Interventions for Urge Incontinence When Combined With Drug Therapy: Adherence Rates, Barriers, and Predictors
Identifieur interne : 000780 ( Pmc/Checkpoint ); précédent : 000779; suivant : 000781Adherence to Behavioral Interventions for Urge Incontinence When Combined With Drug Therapy: Adherence Rates, Barriers, and Predictors
Auteurs : Diane Borello-France [États-Unis] ; Kathryn L. Burgio ; Patricia S. Goode ; Alayne D. Markland ; Kimberly Kenton ; Aarthi Balasubramanyam ; Anne M. StoddardSource :
- Physical Therapy [ 0031-9023 ] ; 2010.
Abstract
Behavioral intervention outcomes for urinary incontinence (UI) depend on active patient participation.
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.
This was a prospectively planned secondary data analysis from a 2-stage, multicenter, randomized clinical trial.
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.
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.
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.
Co-administration of medication for UI may have influenced adherence.
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.
Url:
DOI: 10.2522/ptj.20080387
PubMed: 20671098
PubMed Central: 2949583
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Adherence to Behavioral Interventions for Urge Incontinence When Combined With Drug Therapy: Adherence Rates, Barriers, and Predictors</title><author><name sortKey="Borello France, Diane" sort="Borello France, Diane" uniqKey="Borello France D" first="Diane" last="Borello-France">Diane Borello-France</name><affiliation wicri:level="2"><nlm:aff id="aff1">D. Borello-France, PT, PhD, is Associate Professor, Department of Physical Therapy, Duquesne University, 111 Health Sciences Bldg, Pittsburgh, PA 15282 (USA).</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>D. Borello-France, PT, PhD, is Associate Professor, Department of Physical Therapy, Duquesne University, 111 Health Sciences Bldg, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Burgio, Kathryn L" sort="Burgio, Kathryn L" uniqKey="Burgio K" first="Kathryn L." last="Burgio">Kathryn L. Burgio</name><affiliation><nlm:aff id="aff2">K.L. Burgio, PhD, is Associate Director for Research, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, and Professor of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:aff><wicri:noCountry code="subfield">Alabama.</wicri:noCountry></affiliation></author><author><name sortKey="Goode, Patricia S" sort="Goode, Patricia S" uniqKey="Goode P" first="Patricia S." last="Goode">Patricia S. Goode</name><affiliation><nlm:aff id="aff3">P.S. Goode, MSN, MD, is Associate Director for Clinical Programs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, and Professor of Medicine, University of Alabama at Birmingham.</nlm:aff><wicri:noCountry code="subfield">University of Alabama at Birmingham.</wicri:noCountry></affiliation></author><author><name sortKey="Markland, Alayne D" sort="Markland, Alayne D" uniqKey="Markland A" first="Alayne D." last="Markland">Alayne D. Markland</name><affiliation><nlm:aff id="aff4">A.D. Markland, DO, MSc, is GRECC Investigator and Continence Clinic Director, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, and Assistant Professor of Medicine, University of Alabama at Birmingham.</nlm:aff><wicri:noCountry code="subfield">University of Alabama at Birmingham.</wicri:noCountry></affiliation></author><author><name sortKey="Kenton, Kimberly" sort="Kenton, Kimberly" uniqKey="Kenton K" first="Kimberly" last="Kenton">Kimberly Kenton</name><affiliation><nlm:aff id="aff5">K. Kenton, MD, MS, is Associate Professor, Female Pelvic Medicine and Reconstructive Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois.</nlm:aff><wicri:noCountry code="subfield">Illinois.</wicri:noCountry></affiliation></author><author><name sortKey="Balasubramanyam, Aarthi" sort="Balasubramanyam, Aarthi" uniqKey="Balasubramanyam A" first="Aarthi" last="Balasubramanyam">Aarthi Balasubramanyam</name><affiliation><nlm:aff id="aff6">A. Balasubramanyam, MS, is Senior Biostatistician, Roche Molecular Systems, Pleasanton, California. At the time of the study, she was Statistician, New England Research Institutes, Watertown, Massachusetts.</nlm:aff><wicri:noCountry code="subfield">Massachusetts.</wicri:noCountry></affiliation></author><author><name sortKey="Stoddard, Anne M" sort="Stoddard, Anne M" uniqKey="Stoddard A" first="Anne M." last="Stoddard">Anne M. Stoddard</name><affiliation><nlm:aff id="aff7">A.M. Stoddard, ScD, is Director, Center for Statistical Analysis and Research, New England Research Institutes.</nlm:aff><wicri:noCountry code="subfield">New England Research Institutes.</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff8"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">20671098</idno><idno type="pmc">2949583</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2949583</idno><idno type="RBID">PMC:2949583</idno><idno type="doi">10.2522/ptj.20080387</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">000529</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000529</idno><idno type="wicri:Area/Pmc/Curation">000526</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000526</idno><idno type="wicri:Area/Pmc/Checkpoint">000780</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000780</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Adherence to Behavioral Interventions for Urge Incontinence When Combined With Drug Therapy: Adherence Rates, Barriers, and Predictors</title><author><name sortKey="Borello France, Diane" sort="Borello France, Diane" uniqKey="Borello France D" first="Diane" last="Borello-France">Diane Borello-France</name><affiliation wicri:level="2"><nlm:aff id="aff1">D. Borello-France, PT, PhD, is Associate Professor, Department of Physical Therapy, Duquesne University, 111 Health Sciences Bldg, Pittsburgh, PA 15282 (USA).</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>D. Borello-France, PT, PhD, is Associate Professor, Department of Physical Therapy, Duquesne University, 111 Health Sciences Bldg, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Burgio, Kathryn L" sort="Burgio, Kathryn L" uniqKey="Burgio K" first="Kathryn L." last="Burgio">Kathryn L. Burgio</name><affiliation><nlm:aff id="aff2">K.L. Burgio, PhD, is Associate Director for Research, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, and Professor of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:aff><wicri:noCountry code="subfield">Alabama.</wicri:noCountry></affiliation></author><author><name sortKey="Goode, Patricia S" sort="Goode, Patricia S" uniqKey="Goode P" first="Patricia S." last="Goode">Patricia S. Goode</name><affiliation><nlm:aff id="aff3">P.S. Goode, MSN, MD, is Associate Director for Clinical Programs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, and Professor of Medicine, University of Alabama at Birmingham.</nlm:aff><wicri:noCountry code="subfield">University of Alabama at Birmingham.</wicri:noCountry></affiliation></author><author><name sortKey="Markland, Alayne D" sort="Markland, Alayne D" uniqKey="Markland A" first="Alayne D." last="Markland">Alayne D. Markland</name><affiliation><nlm:aff id="aff4">A.D. Markland, DO, MSc, is GRECC Investigator and Continence Clinic Director, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, and Assistant Professor of Medicine, University of Alabama at Birmingham.</nlm:aff><wicri:noCountry code="subfield">University of Alabama at Birmingham.</wicri:noCountry></affiliation></author><author><name sortKey="Kenton, Kimberly" sort="Kenton, Kimberly" uniqKey="Kenton K" first="Kimberly" last="Kenton">Kimberly Kenton</name><affiliation><nlm:aff id="aff5">K. Kenton, MD, MS, is Associate Professor, Female Pelvic Medicine and Reconstructive Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois.</nlm:aff><wicri:noCountry code="subfield">Illinois.</wicri:noCountry></affiliation></author><author><name sortKey="Balasubramanyam, Aarthi" sort="Balasubramanyam, Aarthi" uniqKey="Balasubramanyam A" first="Aarthi" last="Balasubramanyam">Aarthi Balasubramanyam</name><affiliation><nlm:aff id="aff6">A. Balasubramanyam, MS, is Senior Biostatistician, Roche Molecular Systems, Pleasanton, California. At the time of the study, she was Statistician, New England Research Institutes, Watertown, Massachusetts.</nlm:aff><wicri:noCountry code="subfield">Massachusetts.</wicri:noCountry></affiliation></author><author><name sortKey="Stoddard, Anne M" sort="Stoddard, Anne M" uniqKey="Stoddard A" first="Anne M." last="Stoddard">Anne M. Stoddard</name><affiliation><nlm:aff id="aff7">A.M. Stoddard, ScD, is Director, Center for Statistical Analysis and Research, New England Research Institutes.</nlm:aff><wicri:noCountry code="subfield">New England Research Institutes.</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff8"></nlm:aff></affiliation></author></analytic><series><title level="j">Physical Therapy</title><idno type="ISSN">0031-9023</idno><idno type="eISSN">1538-6724</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Behavioral intervention outcomes for urinary incontinence (UI) depend on active patient participation.</p></sec><sec><title>Objective</title><p>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.</p></sec><sec><title>Design</title><p>This was a prospectively planned secondary data analysis from a 2-stage, multicenter, randomized clinical trial.</p></sec><sec><title>Patients and Intervention</title><p>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.</p></sec><sec><title>Measurements</title><p>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.</p></sec><sec><title>Results</title><p>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.</p></sec><sec><title>Limitations</title><p>Co-administration of medication for UI may have influenced adherence.</p></sec><sec><title>Conclusions</title><p>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.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Phys Ther</journal-id><journal-id journal-id-type="hwp">ptjournal</journal-id><journal-id journal-id-type="pmc">ptjournal</journal-id><journal-id journal-id-type="publisher-id">PTJOURNAL</journal-id><journal-title-group><journal-title>Physical Therapy</journal-title></journal-title-group><issn pub-type="ppub">0031-9023</issn><issn pub-type="epub">1538-6724</issn><publisher><publisher-name>American Physical Therapy Association</publisher-name><publisher-loc>Alexandria, VA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">20671098</article-id><article-id pub-id-type="pmc">2949583</article-id><article-id pub-id-type="publisher-id">2008-0387</article-id><article-id pub-id-type="doi">10.2522/ptj.20080387</article-id><article-categories><subj-group subj-group-type="hwp-journal-coll"><subject>1311</subject><subject>1312</subject><subject>1950</subject><subject>2006</subject><subject>2402</subject></subj-group><subj-group subj-group-type="heading"><subject>Research Reports</subject></subj-group></article-categories><title-group><article-title>Adherence to Behavioral Interventions for Urge Incontinence When Combined With Drug Therapy: Adherence Rates, Barriers, and Predictors</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Borello-France</surname><given-names>Diane</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Burgio</surname><given-names>Kathryn L.</given-names></name><xref ref-type="aff" rid="aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Goode</surname><given-names>Patricia S.</given-names></name><xref ref-type="aff" rid="aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Markland</surname><given-names>Alayne D.</given-names></name><xref ref-type="aff" rid="aff4"></xref></contrib><contrib contrib-type="author"><name><surname>Kenton</surname><given-names>Kimberly</given-names></name><xref ref-type="aff" rid="aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Balasubramanyam</surname><given-names>Aarthi</given-names></name><xref ref-type="aff" rid="aff6"></xref></contrib><contrib contrib-type="author"><name><surname>Stoddard</surname><given-names>Anne M.</given-names></name><xref ref-type="aff" rid="aff7"></xref><xref ref-type="aff" rid="aff8"></xref></contrib><on-behalf-of>for the Urinary Incontinence Treatment Network</on-behalf-of><aff id="aff1">D. Borello-France, PT, PhD, is Associate Professor, Department of Physical Therapy, Duquesne University, 111 Health Sciences Bldg, Pittsburgh, PA 15282 (USA).</aff><aff id="aff2">K.L. Burgio, PhD, is Associate Director for Research, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, and Professor of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.</aff><aff id="aff3">P.S. Goode, MSN, MD, is Associate Director for Clinical Programs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, and Professor of Medicine, University of Alabama at Birmingham.</aff><aff id="aff4">A.D. Markland, DO, MSc, is GRECC Investigator and Continence Clinic Director, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, and Assistant Professor of Medicine, University of Alabama at Birmingham.</aff><aff id="aff5">K. Kenton, MD, MS, is Associate Professor, Female Pelvic Medicine and Reconstructive Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois.</aff><aff id="aff6">A. Balasubramanyam, MS, is Senior Biostatistician, Roche Molecular Systems, Pleasanton, California. At the time of the study, she was Statistician, New England Research Institutes, Watertown, Massachusetts.</aff><aff id="aff7">A.M. Stoddard, ScD, is Director, Center for Statistical Analysis and Research, New England Research Institutes.</aff><aff id="aff8">Urinary Incontinence Treatment Network (see list of investigators and participants in<xref ref-type="app" rid="app1">Appendix 1</xref>).</aff></contrib-group><author-notes><corresp>Address all correspondence to Dr Borello-France at: <email>borellofrance@duq.edu</email>.</corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2010</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>4</month><year>2011</year></pub-date><pmc-comment> PMC Release delay is 6 months and 0 days and was based on the
<volume>90</volume><issue>10</issue><fpage>1493</fpage><lpage>1505</lpage><history><date date-type="received"><day>3</day><month>12</month><year>2008</year></date><date date-type="accepted"><day>1</day><month>6</month><year>2010</year></date></history><permissions><copyright-statement>© 2010 American Physical Therapy Association</copyright-statement></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="zad01010001493.pdf"></self-uri><abstract><sec><title>Background</title><p>Behavioral intervention outcomes for urinary incontinence (UI) depend on active patient participation.</p></sec><sec><title>Objective</title><p>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.</p></sec><sec><title>Design</title><p>This was a prospectively planned secondary data analysis from a 2-stage, multicenter, randomized clinical trial.</p></sec><sec><title>Patients and Intervention</title><p>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.</p></sec><sec><title>Measurements</title><p>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.</p></sec><sec><title>Results</title><p>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.</p></sec><sec><title>Limitations</title><p>Co-administration of medication for UI may have influenced adherence.</p></sec><sec><title>Conclusions</title><p>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.</p></sec></abstract></article-meta></front></pmc><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li></region></list><tree><noCountry><name sortKey="Balasubramanyam, Aarthi" sort="Balasubramanyam, Aarthi" uniqKey="Balasubramanyam A" first="Aarthi" last="Balasubramanyam">Aarthi Balasubramanyam</name><name sortKey="Burgio, Kathryn L" sort="Burgio, Kathryn L" uniqKey="Burgio K" first="Kathryn L." last="Burgio">Kathryn L. Burgio</name><name sortKey="Goode, Patricia S" sort="Goode, Patricia S" uniqKey="Goode P" first="Patricia S." last="Goode">Patricia S. Goode</name><name sortKey="Kenton, Kimberly" sort="Kenton, Kimberly" uniqKey="Kenton K" first="Kimberly" last="Kenton">Kimberly Kenton</name><name sortKey="Markland, Alayne D" sort="Markland, Alayne D" uniqKey="Markland A" first="Alayne D." last="Markland">Alayne D. Markland</name><name sortKey="Stoddard, Anne M" sort="Stoddard, Anne M" uniqKey="Stoddard A" first="Anne M." last="Stoddard">Anne M. Stoddard</name></noCountry><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Borello France, Diane" sort="Borello France, Diane" uniqKey="Borello France D" first="Diane" last="Borello-France">Diane Borello-France</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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