Researchers to provide physiotherapists with incontinence guidelines

24 April 2015

Researchers at Glasgow Caledonian University (GCU) are providing physiotherapists with guidelines for best practice in treating female urinary incontinence.

Urinary incontinence (UI) is a common and distressing problem, affecting one in three women, with prevalence increasing with age.

Around 20% of women with urinary problems seek professional help; this percentage increases with advancing age and is also higher among women with other urogenital problems. However, there are many different approaches to treatment as well as several different causes and types of incontinence.

Funded by the Physiotherapy Research Foundation, GCU’s Dr Doreen McClurg is leading a team from the University’s Nursing, Midwifery and Allied Health Professions Research Unit in conducting a Cochrane Overview of the evidence for treating the problem.

Cochrane Overviews summarise the results of multiple systematic reviews covering different interventions for the same clinical condition, providing clinicians with clear guidance on appropriate intervention evidence to meet the different needs of users. 

It has been recognised that a large and growing body of systematic reviews can be overwhelming for decision makers and healthcare practitioners who do not have time to keep up-to-date with this evidence base. Furthermore, while reviews synthesise available evidence relating to UI in women, they often explore the effects of specific, single interventions compared to placebo or control interventions.

However, physiotherapists will generally have to make a choice between a variety of interventions (or some combination) rather than an ‘all or nothing’ choice of using one of the interventions.

The team will develop an accessible, comprehensive document combining all high-quality evidence about UI rehabilitation interventions, highlighting the limitations of current best evidence and enabling comparisons of the effects of the different interventions. 

This research, lasting a year, will involve stakeholder group meetings and will support evidence-based management of UI among key decision makers including clinicians, policy makers, informed health service users and educators of allied health professionals.

Dr McClurg said: “Conservative management of UI is recommended as a first line of treatment with women being referred to specialist physiotherapists. Patients often have complex conditions and identifying the most effective rehabilitation intervention is not always easy.

“Given the importance of improving or curing these women to allow them to have an active lifestyle, there are a substantive and growing number of randomised controlled trials relating to the effectiveness of rehabilitation interventions aimed at promoting a return to continence. Despite this growing body of evidence, current clinical practice often does not reflect the available increasing evidence base. Lack of sufficient time to identify and synthesise evidence is cited as the key barrier to evidence-utilisation within UI rehabilitation.”