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Long term follow-up of a randomised controlled trial of services for urinary symptoms.

Publication ,  Journal Article
Williams, KS; Coleby, D; Abrams, KR; Turner, DA; Shaw, C; Assassa, RP; Cooper, NJ; Donaldson, MM; McGrother, CW
Published in: BMC Health Serv Res
March 14, 2011

BACKGROUND: Given the extent and priority of urinary symptoms there is little evidence available to inform service provision in relation to the long term effects of interventions. This study aims to determine the long term (6 year) clinical effectiveness and costs of a new continence nurse led service compared to standard care for urinary symptoms. METHODS: A long term follow-up study of a 2-arm, non-blinded randomised controlled trial that recruited from a community based population between 1998-2000 in Leicestershire and Rutland UK was undertaken. 3746 men and women aged 40 years and over were followed up from the original trial. The continence nurse practitioner (CNP) intervention comprised a continence service provided by specially trained nurses delivering evidence-based interventions using pre-determined care pathways. The standard care (SC) arm comprised access to existing primary care including General Practitioner and continence advisory services in the area. PRIMARY OUTCOME: Improvement in one or more symptom. Secondary outcomes included: a) Leicester Impact scale; b) patient perception of problem; c) number of symptoms alleviated and cost-effectiveness; all were recorded at long term follow-up (average 6 years) post-randomisation. RESULTS: Overall at long-term follow-up (average 6 years) significantly more individuals in the CNP group (72%) had improved (i.e had fewer symptoms) compared to those in the SC group (67%) (difference of 5% 95% (CI = 0.6 to 9;p = 0.02)). CONCLUSION: The differences in outcome between the two randomised groups shown immediately post treatment had decreased by half in terms of symptom improvement at long term follow-up. Although the difference was statistically significant, the clinical significance may not be, although the direction of the difference favoured the new CNP service.

Duke Scholars

Published In

BMC Health Serv Res

DOI

EISSN

1472-6963

Publication Date

March 14, 2011

Volume

11

Start / End Page

58

Location

England

Related Subject Headings

  • Urologic Diseases
  • Surveys and Questionnaires
  • Outcome Assessment, Health Care
  • Middle Aged
  • Male
  • Humans
  • Health Services
  • Health Policy & Services
  • Follow-Up Studies
  • Female
 

Citation

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Williams, K. S., Coleby, D., Abrams, K. R., Turner, D. A., Shaw, C., Assassa, R. P., … McGrother, C. W. (2011). Long term follow-up of a randomised controlled trial of services for urinary symptoms. BMC Health Serv Res, 11, 58. https://doi.org/10.1186/1472-6963-11-58
Williams, Kate S., Dawn Coleby, Keith R. Abrams, David A. Turner, Christine Shaw, R Philip Assassa, Nicola J. Cooper, Madeleine Mk Donaldson, and Catherine W. McGrother. “Long term follow-up of a randomised controlled trial of services for urinary symptoms.BMC Health Serv Res 11 (March 14, 2011): 58. https://doi.org/10.1186/1472-6963-11-58.
Williams KS, Coleby D, Abrams KR, Turner DA, Shaw C, Assassa RP, et al. Long term follow-up of a randomised controlled trial of services for urinary symptoms. BMC Health Serv Res. 2011 Mar 14;11:58.
Williams, Kate S., et al. “Long term follow-up of a randomised controlled trial of services for urinary symptoms.BMC Health Serv Res, vol. 11, Mar. 2011, p. 58. Pubmed, doi:10.1186/1472-6963-11-58.
Williams KS, Coleby D, Abrams KR, Turner DA, Shaw C, Assassa RP, Cooper NJ, Donaldson MM, McGrother CW. Long term follow-up of a randomised controlled trial of services for urinary symptoms. BMC Health Serv Res. 2011 Mar 14;11:58.
Journal cover image

Published In

BMC Health Serv Res

DOI

EISSN

1472-6963

Publication Date

March 14, 2011

Volume

11

Start / End Page

58

Location

England

Related Subject Headings

  • Urologic Diseases
  • Surveys and Questionnaires
  • Outcome Assessment, Health Care
  • Middle Aged
  • Male
  • Humans
  • Health Services
  • Health Policy & Services
  • Follow-Up Studies
  • Female