TY - JOUR
T1 - Identifying continence options after stroke (ICONS)
T2 - A cluster randomised controlled feasibility trial
AU - Thomas, Lois H.
AU - Watkins, Caroline L.
AU - Sutton, Christopher J.
AU - Forshaw, Denise
AU - Leathley, Michael J.
AU - French, Beverley
AU - Burton, Christopher R.
AU - Cheater, Francine
AU - Roe, Brenda
AU - Britt, David
AU - Booth, Joanne
AU - McColl, Elaine
AU - Leathley, Michael
AU - Carter, Bernadette
AU - Booth, Jo
AU - Burton, Christopher
AU - Rodgers, Helen
AU - Brittain, Katie
AU - Walker, Andrew
AU - Barrett, James
AU - Whiteley, Gemma
AU - Brand, Pat
AU - Griffiths, May
AU - Helvin, Philip
AU - James, Brian
AU - Pearl, Gill
AU - Whitewood, Jane
AU - Vella, Jacqui
AU - Childs, Richard
AU - Crosby, Sean
AU - Hall, Steve
AU - Lewin, Anj
AU - Royle, Liz
AU - Scott, Carole
AU - Wright, Jean
AU - ICONS Project Team
AU - ICONS Patient, Public and Carer Involvement Groups
PY - 2014/12/23
Y1 - 2014/12/23
N2 - Background: Urinary incontinence (UI) affects half of patients hospitalised after stroke and is often poorly managed. Cochrane systematic reviews have shown some positive impact of conservative interventions (such as bladder training) in reducing UI, but their effectiveness has not been demonstrated with stroke patients. Methods: We conducted a cluster randomised controlled feasibility trial of a systematic voiding programme (SVP) for the management of UI after stroke. Stroke services were randomised to receive SVP (n = 4), SVP plus supported implementation (SVP+, n = 4), or usual care (UC, n = 4). Results: It was possible to recruit patients (413; 164 SVP, 125 SVP+, and 124 UC) and participant retention was acceptable (85% and 88% at six and 12 weeks, respectively). There was no suggestion of a beneficial effect on the main outcome at six (SVP versus UC: odds ratio (OR) 0.94, 95% CI: 0.46 to 1.94; SVP+ versus UC: OR: 0.62, 95% CI: 0.28 to 1.37) or 12 weeks (SVP versus UC: OR: 1.02, 95% CI: 0.54 to 1.93; SVP+ versus UC: OR: 1.06, 95% CI: 0.54 to 2.09). Conclusions: The trial has met feasibility outcomes of participant recruitment and retention. It was not powered to demonstrate effectiveness, but there is some evidence of a potential reduction in the odds of specific types of incontinence. A full trial should now be considered.
AB - Background: Urinary incontinence (UI) affects half of patients hospitalised after stroke and is often poorly managed. Cochrane systematic reviews have shown some positive impact of conservative interventions (such as bladder training) in reducing UI, but their effectiveness has not been demonstrated with stroke patients. Methods: We conducted a cluster randomised controlled feasibility trial of a systematic voiding programme (SVP) for the management of UI after stroke. Stroke services were randomised to receive SVP (n = 4), SVP plus supported implementation (SVP+, n = 4), or usual care (UC, n = 4). Results: It was possible to recruit patients (413; 164 SVP, 125 SVP+, and 124 UC) and participant retention was acceptable (85% and 88% at six and 12 weeks, respectively). There was no suggestion of a beneficial effect on the main outcome at six (SVP versus UC: odds ratio (OR) 0.94, 95% CI: 0.46 to 1.94; SVP+ versus UC: OR: 0.62, 95% CI: 0.28 to 1.37) or 12 weeks (SVP versus UC: OR: 1.02, 95% CI: 0.54 to 1.93; SVP+ versus UC: OR: 1.06, 95% CI: 0.54 to 2.09). Conclusions: The trial has met feasibility outcomes of participant recruitment and retention. It was not powered to demonstrate effectiveness, but there is some evidence of a potential reduction in the odds of specific types of incontinence. A full trial should now be considered.
KW - Cluster randomised controlled trial
KW - Feasibility
KW - Stroke
KW - Urinary incontinence
UR - http://www.scopus.com/inward/record.url?scp=84928653325&partnerID=8YFLogxK
U2 - 10.1186/1745-6215-15-509
DO - 10.1186/1745-6215-15-509
M3 - Article
C2 - 25539714
AN - SCOPUS:84928653325
SN - 1745-6215
VL - 15
JO - Trials
JF - Trials
IS - 1
M1 - 509
ER -
