235 lines
No EOL
14 KiB
HTML
235 lines
No EOL
14 KiB
HTML
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
|
|
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
|
|
<html xmlns="http://www.w3.org/1999/xhtml">
|
|
<head>
|
|
<title>Research Activities, May 1996: Clinical Practice Guidelines: AHCPR releases update to urinary incontinence guideline</title>
|
|
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
|
|
|
|
<!-- "metadata" -->
|
|
<meta name="Title" content="Research Activities, May 1996" />
|
|
<meta name="keywords" content="Agency for Health Care Policy and Research, Agency for Healthcare Research and Quality, AHRQ, AHCPR, AIDS/HIV, ambulatory care, benchmark, child, cost, elderly, health cost, healthcare cost, hospital, long-term care, managed care, markets, mental health, methodology, minority health, nursing, nursing homes, outcome research, out-of-pocket spending, patient care, primary, primary care, research, rural, spending, study, Translating Research Into Practice, TRIP" />
|
|
<meta name="description" content="Online newsletter summarizing published findings from AHRQ-funded studies, new AHRQ publications and products, and funding opportunities." />
|
|
<meta name="creator" content="Agency for Healthcare Research and Quality (AHRQ)" />
|
|
<meta name="language" content="English" />
|
|
<!-- end metadata -->
|
|
<link href="/includes/archive.css" rel="stylesheet" type="text/css" />
|
|
<link href="/includes/ahrqstyleprint_arch.css" rel="stylesheet" type="text/css" media="print" />
|
|
<script>
|
|
(function(i,s,o,g,r,a,m){i['GoogleAnalyticsObject']=r;i[r]=i[r]||function(){
|
|
(i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o),
|
|
m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m)
|
|
})(window,document,'script','//www.google-analytics.com/analytics.js','ga');
|
|
|
|
ga('create', 'UA-75759936-1', 'auto');
|
|
ga(' set', 'anonymizeIp', true);
|
|
|
|
ga('send', 'pageview');
|
|
|
|
</script></head><body><!-- Google Tag Manager -->
|
|
<noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-W4DST4"
|
|
height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
|
|
<script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
|
|
new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],
|
|
j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src=
|
|
'//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);
|
|
})(window,document,'script','dataLayer','GTM-W4DST4');</script>
|
|
<!-- End Google Tag Manager -->
|
|
<noscript>
|
|
Your browser doesn't support JavaScript. Please upgrade to a modern browser or enable JavaScript in your existing browser.
|
|
</noscript>
|
|
|
|
<!-- Page Header v2.0 -->
|
|
<a name="top" id="top"></a>
|
|
<!--Begin Banner CodeS-->
|
|
<div id="ahrqbanner">
|
|
<div class="hhsportion">
|
|
<a href="#h1" class="skipnav">Skip Navigation</a>
|
|
<a href="http://www.hhs.gov" title="U.S. Department of Health and Human Services">
|
|
<img src="/images/hhs_banner.gif" alt="U.S. Department of Health and Human Services" />
|
|
</a>
|
|
<a href="http://www.hhs.gov" title="www.hhs.gov" class="hhsright">
|
|
<img src="/images/hhs_link.gif" alt="www.hhs.gov" />
|
|
</a>
|
|
</div>
|
|
|
|
<div class="ahrqportion">
|
|
<a href="/" title="Archive: Agency for Healthcare Research Quality">
|
|
<img src="/images/ahrq_banner.gif" alt="Agency for Healthcare Research Quality" />
|
|
</a><form name="searchForm" method="get" action="https://search.ahrq.gov/search" id="banner_searchform">
|
|
<label for="search" style="z-index:-1;position:relative;margin-right:-65px; font-size:0px;">Search</label>
|
|
<input name="q" type="text" value=" Search Archive" size="11" onfocus="this.value='';" class="gotext" label="Search archive" id="search" />
|
|
<input type="hidden" name="entqr" value="0" />
|
|
<input type="hidden" name="output" value="xml_no_dtd" />
|
|
<input type="hidden" name="proxystylesheet" value="ARCHIVE_Front_End" />
|
|
<input type="hidden" name="client" value="ARCHIVE_Front_End" />
|
|
<input type="hidden" name="site" value="ARCHIVE_AHRQ_GOV" />
|
|
<input src="/images/topbn_GoButton.gif" class="gobtn" name="Submit" onclick="javascript:document.searchForm.submit();" type="image" alt="Search" />
|
|
</form>
|
|
<a href="https://www.ahrq.gov/" class="ahrqright">www.ahrq.gov</a>
|
|
</div><div class="ahrqlinks"><a href="https://www.ahrq.gov/">AHRQ Home—Live Site</a> | <a href="/">Archive Home</a> | <a href="/sitemap.htm">Site Map</a> <!-- | <img src="/images/envelope1.jpg" alt="" width="21" height="14" /><a href="https://subscriptions.ahrq.gov/service/multi_subscribe.html?code=USAHRQ">E-mail Updates</a> --></div>
|
|
</div>
|
|
<div id="PrintBanner">
|
|
<img src="/images/printbanner_arch.jpg" alt="Archive print banner" />
|
|
</div>
|
|
<a name="h1"></a>
|
|
<!-- End banner code -->
|
|
<!-- End of Page header -->
|
|
|
|
<!-- Content Body -->
|
|
<div id="mainContent">
|
|
<table width="100%" border="0" cellspacing="0" cellpadding="0" >
|
|
<tr valign="top">
|
|
<td width="70%">
|
|
<!-- Center Content section -->
|
|
<table width="100%" border="0" cellpadding="0" cellspacing="0" style="margin-left:10px; margin-right:10px;margin-top:5px" summary="This table gives the layout format of the bread crumb area and the center content area.">
|
|
<!--DWLayoutTable-->
|
|
<tr>
|
|
<td class="crumb_link"><div id="crumbContent">
|
|
<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> > <a href="/research/resarch.htm" class="crumb_link"><em>Research Activities</em> Archive</a> > <a href="." class="crumb_link">May 1996</a>
|
|
</span></p>
|
|
</div>
|
|
</td>
|
|
</tr>
|
|
<tr>
|
|
<td><h1><a name="h1" id="h1"></a> Clinical Practice Guidelines </h1>
|
|
</td>
|
|
</tr>
|
|
<tr>
|
|
<td><div id="centerContent"><div class="headnote">
|
|
<p>This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: <a href="https://info.ahrq.gov/">https://info.ahrq.gov</a>. Let us know the nature of the problem, the Web address of what you want, and your contact information. </p>
|
|
|
|
|
|
<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
|
|
<a name="head1"></a>
|
|
<h2>AHCPR releases update to urinary incontinence guideline</h2>
|
|
<p>The Agency for Health Care Policy and Research recently released
|
|
an updated version of its clinical practice guideline on urinary
|
|
incontinence (UI) first issued in March of 1992. The updated
|
|
guideline has expanded sections on diagnosis and behavioral
|
|
therapies, as well as a new chapter on treating chronic UI in
|
|
long-term and home care settings.</p><p>
|
|
|
|
Urinary incontinence is one of the primary contributing reasons
|
|
that people enter nursing facilities, yet 80 percent of cases can
|
|
be improved or cured by following the guideline's
|
|
recommendations. Use of the guideline may help people stay at
|
|
home longer and improve the quality of life for persons at home
|
|
or in facilities.</p>
|
|
|
|
<p>Researchers estimate the Nation spends at least $16 billion a
|
|
year to care for people with UI, up from $10 billion in 1990.
|
|
Urinary incontinence is estimated to affect more than 13 million
|
|
adults—most of them older women—but actual prevalence
|
|
may be higher because it is widely underreported and
|
|
underdiagnosed.</p><p>
|
|
|
|
As with the first version, this updated guideline was developed
|
|
by a private sector, multidisciplinary panel of clinicians and a
|
|
consumer. The panel was co-chaired by Andrew J. Fantl, M.D.,
|
|
Professor and Vice-Chair of the Obstetrics, Gynecology, and
|
|
Reproductive Medicine Department at SUNY at Stonybrook School of
|
|
Medicine, and Diane Kaschak Newman, R.N.C., M.S.N., F.A.A.N.,
|
|
President of Access to Continence Care and Treatment,
|
|
Philadelphia, PA.</p>
|
|
|
|
<p>Incontinence can be caused by pelvic muscle instability, as a
|
|
side effect of medications or caffeine, or other conditions such
|
|
as a urinary tract infection or constipation. It also can be
|
|
caused by not being able to reach the bathroom in time due to a
|
|
lack of mobility. Many younger women experience incontinence
|
|
after childbirth but don't report it because they are
|
|
embarrassed or feel it is an inevitable result of the birthing
|
|
process. Older men with prostate problems or recovering from
|
|
prostate surgery often suffer from incontinence but are more
|
|
likely to ask for and receive help for the condition.</p><p>
|
|
|
|
According to the guideline panel co-chairs, surveys have shown
|
|
that women tend to accept incontinence as their personal burden,
|
|
while men understand that UI is not normal and should be treated.
|
|
They point out that clinicians need to ask women about
|
|
incontinence and treat it aggressively.</p>
|
|
|
|
<p>The guideline is written for the primary care provider and covers
|
|
various types of incontinence, provides a framework for selecting
|
|
appropriate behavioral, pharmacologic, and surgical treatments,
|
|
and evaluates the use of alternative treatments such as catheters
|
|
and bladder support devices.</p><p>
|
|
|
|
AHCPR is working collaboratively with the American Medical
|
|
Directors Association (AMDA) and the American Health Care
|
|
Association (AHCA) to develop new materials to increase
|
|
caregivers' understanding of UI. The caregiver guide will be
|
|
written specifically for certified nursing assistants in nursing
|
|
facilities and home health aides. A companion piece will be
|
|
written for directors of nursing to help them train caregivers.
|
|
The new materials will be available later this summer.</p>
|
|
|
|
<p>The American Medical Directors Association is a national
|
|
professional organization representing physicians who practice in
|
|
long-term care facilities as medical directors or attending
|
|
physicians. The American Health Care Association is a federation
|
|
of 51 State associations representing more than 11,000 long-term
|
|
care facilities nationwide, caring for more than 1 million
|
|
elderly, chronically ill, and convalescent Americans.</p><p>
|
|
|
|
A quick reference guide for clinicians,<em> Managing Acute and
|
|
Chronic Urinary Incontinence</em> (AHCPR Publication No. 96-0686),
|
|
and a consumer guide, <em>Understanding Incontinence</em>, in
|
|
English (AHCPR Publication No. 96-0684) or Spanish (AHCPR
|
|
Publication No. 96-0685), are available from AHCPR.</p>
|
|
|
|
<p>Single and bulk copies of the complete clinical practice
|
|
guideline, <em>Urinary Incontinence in Adults: Acute and Chronic
|
|
Management</em>, are available from the Superintendent of
|
|
Documents, U.S. Government Printing Office (stock number
|
|
017-026-00155-7; $6 per copy). Bulk copies of the quick reference
|
|
guide (stock number 017-026-00156-5, $27 per pack of 20) and the
|
|
consumer guide (English only; stock number 017-026-00157-3, $10
|
|
per pack of 20) also are available from GPO. To order, call the
|
|
GPO order desk at (202) 512-1800 (credit card and deposit account
|
|
orders only) or write to Superintendent of Documents, P.O. Box
|
|
371954, Pittsburgh, PA 15205-7954.</p><p>
|
|
|
|
Select for the UI <a href="http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat6.chapter.9995">guideline</a>, <a href="http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat6.chapter.32554">quick reference guide</a>, and <a href="http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat6.chapter.35431">English</a> and <a href="http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat6.chapter.37152">Spanish</a> consumer guides.</p>
|
|
|
|
<p><strong>Editor's Note:</strong> As explained in <a href="/research/apr96/dept9.htm#head3">Administrator
|
|
testifies in support of AHCPR's FY 97 budget</a>, AHCPR has implemented a new policy on
|
|
clinical practice guidelines. AHCPR will no longer be directly involved in guideline development
|
|
but will work as a "science partner" with private-sector groups to supply the scientific evidence
|
|
they need to develop their own clinical practice guidelines.]</p>
|
|
|
|
<p class="size2"><a href=".">Return to Contents</a><br />
|
|
<a href="dept6.htm">Proceed to Next Section</a></p>
|
|
<div class="footnote">
|
|
<p> The information on this page is archived and provided for reference purposes only.</p></div>
|
|
<p> </p>
|
|
</div>
|
|
</td>
|
|
</tr>
|
|
</table>
|
|
<!-- End of Center Content section -->
|
|
</td>
|
|
</tr>
|
|
</table>
|
|
</div>
|
|
<!-- End of Content Body -->
|
|
<!-- Footer graphic 1.2-->
|
|
<table cellspacing="0" cellpadding="0" border="0" width="100%">
|
|
<tr>
|
|
<td width="125" background="/images/bottom_ahrq_bkg.jpg"><img src="/images/bottom_ahrq_1.jpg" width="125" alt="AHRQ" /></td>
|
|
<td width="100%" background="/images/bottom_ahrq_bkg.jpg" ><img src="/images/bottom_ahrq_bkg.jpg" width="10" height="34" alt="" /></td>
|
|
|
|
<td width="310" background="/images/bottom_ahrq_bkg.jpg"><img src="/images/bottom_ahrq_2.gif" alt="Advancing Excellence in Health Care" width="310" height="34" /></td>
|
|
</tr>
|
|
</table>
|
|
<!-- Footer links section -->
|
|
<div id="banner_Footer2"><p> <a href="https://www.ahrq.gov/">AHRQ Home</a> | <a href="https://info.ahrq.gov" class="footer_navlink">Questions?</a> | <a href="https://www.ahrq.gov/contact/index.html" class="footer_navlink">Contact AHRQ</a> | <a href="https://www.ahrq.gov/sitemap.html" class="footer_navlink">Site Map</a> | <a href="https://www.ahrq.gov/policy/electronic/accessibility/index.html" class="footer_navlink">Accessibility</a> | <a href="https://www.ahrq.gov/policy/electronic/privacy/index.html" class="footer_navlink">Privacy
|
|
Policy</a> | <a href="https://www.ahrq.gov/policy/foia/index.html" class="footer_navlink">Freedom of Information Act</a> | <a href="https://www.ahrq.gov/policy/electronic/disclaimers/index.html" class="footer_navlink">Disclaimers</a> | <a href="http://www.hhs.gov/open/recordsandreports/plainwritingact/index.html" class="footer_navlink">Plain Writing Act</a> <br />
|
|
|
|
<a href="http://www.hhs.gov" class="footer_navlink">U.S. Department of Health & Human Services</a> | <a href="http://www.whitehouse.gov" class="footer_navlink">The White House</a> | <a href="http://www.usa.gov" class="footer_navlink">USA.gov: The U.S. Government's Official Web Portal</a></p>
|
|
</div>
|
|
<div id="banner_Footeraddress"><p>Agency for Healthcare Research and Quality <img src="/images/bottom_dot.gif" alt="" /> 5600 Fishers Lane Rockville, MD 20857 <img src="/images/bottom_dot.gif" alt="" /> Telephone: (301) 427-1364</p></div>
|
|
|
|
<!-- End of Footer links section -->
|
|
</body>
|
|
</html> |