Regular reminding to prompt going to the toilet for the management of urinary incontinence in adults

Eustice S, Roe B, Paterson J

Published Online:

January 21, 2009

Urinary incontinence is very common amongst elderly long-term residents of nursing homes or hospitals. Prompted voiding is a behavioural therapy used mainly in North American nursing homes. It aims to improve bladder control for people with or without dementia using verbal prompts and positive reinforcement. The review found that although there is suggestive evidence of short-term benefit from prompted voiding, it is not known if these persist. Prompted voiding is also resource-intensive for nursing staff. Prompted voiding can take up a lot of carers time and this hinders its wider use. There was no evidence about long-term effects.

Abstract (click to read)

Background:

Prompted voiding is a behavioural therapy used mainly in North American nursing homes. It aims to improve bladder control for people with or without dementia using verbal prompts and positive reinforcement.

Objectives:

To assess the effects of prompted voiding for the management of urinary incontinence in adults.

Search strategy:

We searched the Cochrane Incontinence Group Specialised Trials Register (searched 31 January 2006) and reference lists of relevant articles. We contacted investigators in the field to locate extra studies.

Selection criteria:

All randomised or quasi-randomised trials which addressed prompted voiding for the management of urinary incontinence. The trials included adult men and women, with or without cognitive impairment, diagnosed as having urinary incontinence as identified by the trialists, either by symptom classification or by urodynamic investigation.

Data collection and analysis:

The identified reports were assessed for eligibility. Two reviewers independently reviewed the selected studies for methodological quality. Data describing six pre-specified outcomes were extracted independently by each reviewer and consensus reached when there was disagreement. Trial investigators were consulted when clarification or further detail was required. A third reviewer was recruited to proof read the review at different stages.

Main results:

Nine trials were included in the review. These involved 674 elderly people, the majority of whom were women. Prompted voiding was compared with no prompted voiding in nine trials. The limited evidence suggested that prompted voiding increased self-initiated voiding and decreased incontinent episodes in the short-term. There was no evidence about whether these effects are sustained over a long period of prompted voiding, or persist after stopping prompted voiding.

Authors' conclusions:

There was insufficient evidence to reach firm conclusions for practice. There was suggestive evidence of short-term benefit from prompted voiding, but longer-term effects are not known, and prompted voiding has significant resource implications.

This record should be cited as:

Eustice S, Roe B, Paterson J. Prompted voiding for the management of urinary incontinence in adults. Cochrane Database of Systematic Reviews 2000, Issue 2. Art. No.: CD002113. DOI: 10.1002/14651858.CD002113

Assessed as up to date:

January 31, 2006

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Primary Review Group:

Incontinence Group

Health topics:

Gynaecology > Urinary incontinence > Psychological treatment

Urology > Incontinence > Psychological treatment

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Regular reminding to prompt going to the toilet for the management of urinary incontinence in adults

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