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...
Autores principales: | , |
---|---|
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 |
_version_ | 1783394516206616576 |
---|---|
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. |
format | Online Article Text |
id | pubmed-6371153 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT yoorhena continencepromotionandsuccessfulagingtheroleofthemultidisciplinarycontinenceclinic AT spencermartha continencepromotionandsuccessfulagingtheroleofthemultidisciplinarycontinenceclinic |