Premium
To what extent are national guidelines for the management of urinary incontinence in women adhered? Data from a national audit
Author(s) -
Wagg A,
Duckett J,
McClurg D,
Harari D,
Lowe D
Publication year - 2011
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2011.03100.x
Subject(s) - nice , medicine , urinary incontinence , audit , excellence , family medicine , confidentiality , surgery , management , computer science , political science , law , economics , programming language
Please cite this paper as: Wagg A, Duckett J, McClurg D, Harari D, Lowe D. To what extent are national guidelines for the management of urinary incontinence in women adhered? Data from a national audit. BJOG 2011;118:1592–1600. Objective To assess the degree of adherence to the current National Institute for Health and Clinical Excellence (NICE) guidelines on the management of urinary incontinence (UI) in women. Design Retrospective survey of consecutive female inpatients and outpatients with UI as part of a national audit. Setting NHS hospital and primary care (PC) trusts. Population or sample Twenty‐five women <65 years old and 25 women ≥65 years old from each participating site. Method All NHS trusts in England, Wales and Northern Ireland were eligible to participate. A web‐based data collection form aligned to the NICE guidelines was constructed for the study. All data submitted to the audit were anonymous and access to the web‐tool was password‐protected for confidentiality. Results Data were returned by 128 acute and 75 PC trusts on 7846 women. No diagnosis was documented in 6.8% (153/2254) of younger and 28% (571/2011) of older women in hospitals ( P < 0.001), and by 8.6% (123/1435) of younger and 21% (380/1786) of older women in PC trusts. In hospitals, 26% (396/1524) of younger women and 15% (182/1231) of older women ( P < 0.001) and in PC trusts 8.2% (77/934) of younger and 4.7% (46/975) of older women underwent multichannel cystometry before conservative therapy. Documentation of discussion of causes and treatment of UI occurred in 76% (1717/2254) of younger and 44% (884/2011) of older women in hospitals ( P < 0.001) and in 75% (1080/1435) of younger and 53% (948/1786) of older women in PC trusts ( P < 0.001). Conclusion Older women are less likely to receive NICE compliant management. Adherence varies according to recommendation. There needs to be concentration on evidence‐based community provision of care by competent and interested clinicians before the aims of the NICE guidelines are met.