Continence Promotion and Successful Aging: The Role of the Multidisciplinary Continence Clinic

Incontinence is a common yet under-recognized issue that impacts quality of life, especially for older adults in whom there is often a multifactorial etiology. A retrospective chart review was performed on a representative sample of patients seen at our multidisciplinary continence clinic in Vancouv...

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Autores principales: Yoo, Rhena, Spencer, Martha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371153/
https://www.ncbi.nlm.nih.gov/pubmed/31011126
http://dx.doi.org/10.3390/geriatrics3040091
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author Yoo, Rhena
Spencer, Martha
author_facet Yoo, Rhena
Spencer, Martha
author_sort Yoo, Rhena
collection PubMed
description Incontinence is a common yet under-recognized issue that impacts quality of life, especially for older adults in whom there is often a multifactorial etiology. A retrospective chart review was performed on a representative sample of patients seen at our multidisciplinary continence clinic in Vancouver, Canada from January to December 2017 inclusive. Initial assessment was performed by the nurse continence advisor (NCA) or geriatrician depending on the source of referral. The pelvic floor physiotherapist (PFP) could then be consulted based on perceived need. The average age at assessment was 76 years old (range 29–102), with 82% of patients ≥65 years and 27% ≥85 years old. The majority of patients were referred for bladder incontinence (72%), with the remaining patients referred for bowel incontinence (28%) or pessary care (7%). Referrals came from a variety of sources including physicians (62%), nurses (22%), allied health care providers (12%) and self-referral (5%). Multimorbidity was common, with 40% of patients having a Charlson Comorbidity Index ≥6. The same proportion of patients (40%) were on ≥5 prescription medications. Many patients were functionally dependent for either instrumental activities of daily living (52%) or activities of daily living (25%). Non-pharmacologic treatments were commonly recommended, with the majority of patients counselled on lifestyle changes (88%) and taught Kegel exercises (70%). For patients seen by the geriatrician, modifications were made to non-continence medications in 50% of cases and medical comorbidities were optimized in 39% of cases. In terms of pharmacologic therapy, over-the-counter (OTC) medications were initiated in 45% of patients whereas continence-specific prescription medications were started in 17% of patients. A multidisciplinary continence clinic can play an important role in promoting successful aging by assessing and treating medical causes of incontinence in medically complex older adults.
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spelling pubmed-63711532019-03-07 Continence Promotion and Successful Aging: The Role of the Multidisciplinary Continence Clinic Yoo, Rhena Spencer, Martha Geriatrics (Basel) Article Incontinence is a common yet under-recognized issue that impacts quality of life, especially for older adults in whom there is often a multifactorial etiology. A retrospective chart review was performed on a representative sample of patients seen at our multidisciplinary continence clinic in Vancouver, Canada from January to December 2017 inclusive. Initial assessment was performed by the nurse continence advisor (NCA) or geriatrician depending on the source of referral. The pelvic floor physiotherapist (PFP) could then be consulted based on perceived need. The average age at assessment was 76 years old (range 29–102), with 82% of patients ≥65 years and 27% ≥85 years old. The majority of patients were referred for bladder incontinence (72%), with the remaining patients referred for bowel incontinence (28%) or pessary care (7%). Referrals came from a variety of sources including physicians (62%), nurses (22%), allied health care providers (12%) and self-referral (5%). Multimorbidity was common, with 40% of patients having a Charlson Comorbidity Index ≥6. The same proportion of patients (40%) were on ≥5 prescription medications. Many patients were functionally dependent for either instrumental activities of daily living (52%) or activities of daily living (25%). Non-pharmacologic treatments were commonly recommended, with the majority of patients counselled on lifestyle changes (88%) and taught Kegel exercises (70%). For patients seen by the geriatrician, modifications were made to non-continence medications in 50% of cases and medical comorbidities were optimized in 39% of cases. In terms of pharmacologic therapy, over-the-counter (OTC) medications were initiated in 45% of patients whereas continence-specific prescription medications were started in 17% of patients. A multidisciplinary continence clinic can play an important role in promoting successful aging by assessing and treating medical causes of incontinence in medically complex older adults. MDPI 2018-12-16 /pmc/articles/PMC6371153/ /pubmed/31011126 http://dx.doi.org/10.3390/geriatrics3040091 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yoo, Rhena
Spencer, Martha
Continence Promotion and Successful Aging: The Role of the Multidisciplinary Continence Clinic
title Continence Promotion and Successful Aging: The Role of the Multidisciplinary Continence Clinic
title_full Continence Promotion and Successful Aging: The Role of the Multidisciplinary Continence Clinic
title_fullStr Continence Promotion and Successful Aging: The Role of the Multidisciplinary Continence Clinic
title_full_unstemmed Continence Promotion and Successful Aging: The Role of the Multidisciplinary Continence Clinic
title_short Continence Promotion and Successful Aging: The Role of the Multidisciplinary Continence Clinic
title_sort continence promotion and successful aging: the role of the multidisciplinary continence clinic
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371153/
https://www.ncbi.nlm.nih.gov/pubmed/31011126
http://dx.doi.org/10.3390/geriatrics3040091
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