title: Patient-reported impact of urinary incontinence--results from treatment seeking women in 14 European countries.
abstract: OBJECTIVE
  To describe the patient-reported impact of urinary incontinence (UI) in treatment-seeking women in Europe.
  
  
  METHODS
  PURE was a non-interventional, observational study, which aimed to describe the direct costs of treatment for European women seeking treatment for UI. A secondary study objective was to describe the impact of UI on health-related quality of life (HRQoL) by UI subtype and severity of disease. This paper presents the results from quality of life assessments as well as bothersomeness and interference with daily activities from the first study observation.
  
  
  METHODS
  Nine thousand four hundred and eighty-seven European women who had UI symptoms in the last 12 months were enrolled. Their UI symptoms were frequently those defined as mixed urinary incontinence (MUI) and were moderate to severe in nature.
  
  
  METHODS
  HRQoL was assessed at the first observation using the urinary Incontinence-specific Quality of Life Questionnaire (I-QOL) and the EQ-5D, a generic quality of life questionnaire. Data collected from EQ-5D provided insight into the patients' general health perception, while the I-QOL data indicated how affected the women were about their UI symptoms. Higher EQ-5D and I-QOL scores represent better quality of life. Patients were asked to indicate how much UI symptoms limited selected activities and to indicate the degree to which they found their symptoms to be bothersome.
  
  
  RESULTS
  Overall, the median self-rated health status on the EQ-5D visual analogue scale (VAS) was 70.0 and the median EQ-5D health state index was 0.85, with small but noticeable differences observed between countries. Of the five health dimensions of the EQ-5D, patients' self-care appeared to be the least affected by UI, with fewer than 10% of the women reporting that they had some problems. Between 20 and 40% of patients had some problems with their mobility and usual activities, or had pain/discomfort or anxiety/depression. However, the impact of existing co-morbidity was not assessed and may have affected some women's scoring of the EQ-5D domains. The mean total I-QOL score overall was 57.7 and of the three subscales of the I-QOL, psychosocial impact had the highest overall scores, representing fewer problems, with lower scores observed for the avoidance and limiting behaviour subscale, and even lower scores for the social embarrassment subscale. The greatest patient-reported impact of UI symptoms on activities was on exercise, with more than 45% of patients moderately to totally limited in this activity. In most of the countries, more than 60% of the women reported that they were moderately to extremely bothered by their UI symptoms.
  
  
  CONCLUSIONS
  There was considerable impact of UI on HRQoL in a treatment seeking population, as demonstrated by the disease-specific quality of life scale and by the high percentage of patients who were bothered by their symptoms.
authors.affiliation: Boehringer Ingelheim GmbH, Health Economics & Outcomes Research, Ingelheim, Germany. Brigitta.Monz@ing.boehringer-ingelheim.com
authors.forename: Brigitta
authors.initials: B
authors.lastname: Monz
authors.forename: Montserrat Espuna
authors.initials: ME
authors.lastname: Pons
authors.forename: Christian
authors.initials: C
authors.lastname: Hampel
authors.forename: Steinar
authors.initials: S
authors.lastname: Hunskaar
authors.forename: Deborah
authors.initials: D
authors.lastname: Quail
authors.forename: Goran
authors.initials: G
authors.lastname: Samsioe
authors.forename: David
authors.initials: D
authors.lastname: Sykes
authors.forename: Adrian
authors.initials: A
authors.lastname: Wagg
authors.forename: Sotiria
authors.initials: S
authors.lastname: Papanicolaou
mesh_terms: D000368:Aged; D005060:Europe / Q000453:epidemiology; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*