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BEHAVIORAL THERAPY CAN REDUCE URINARY INCONTINENCE.

Urinary incontinence is one of the most common and costly problems elderly patients have. Hu and colleagues conducted a randomized trial of a behavior therapy program designed to reduce incontinence in 133 female nursing home patients with daytime incontinence and sufficient neurologic function to recognize their own names. The 13-week intervention consisted of nursing home staff checking patients for wetness hourly during the day and prompting them to use the toilet if necessary. This approach was designed to teach patients how to recognize muscular cues associated with bladder fullness and to provide social reinforcement for asking for assistance in reaching the lavatory.

Incontinence was reduced in the treatment group by an average of about 0.5 episodes per day, or 22 percent. This improvement was sustained during six months of follow-up. Although the intervention did not lead to full continence, the results are encouraging because most of the patients were cognitively impaired and would be expected to be resistant to such treatment. These findings demonstrate that patients with incontinence, even those who are otherwise severely incapacitated, can be treated.

— THL

Published in Journal Watch General Medicine May 16, 1989

Citation(s):

Hu TW et al. A clinical trial of a behavioral therapy to reduce urinary incontinence in nursing homes. JAMA 1989 May 12 261 2656-2662.

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