title: The effect of systematic screening of older women for urinary incontinence on treatment uptake: the URINO trial.
abstract: BACKGROUND
  Female urinary incontinence is a common condition that has a negative influence on quality of life and generates high costs, but spontaneous help-seeking is limited. In the URINO trial the effects and cost-effectiveness of actively encouraging older women to undergo diagnostics and treatment for urinary incontinence were compared with usual care.
  
  
  OBJECTIVE
  To describe the design of the URINO trial and to give data on the effect of treatment uptake after screening. In the discussion, the criteria of Wilson and Jungner are applied to discuss whether screening for urinary incontinence is suitable.
  
  
  METHODS
  In a cluster randomized trial all registered female patients aged ≥55 years received a screening questionnaire. The intervention consisted of actively encouraging women to undergo diagnostics, after which tailored treatment was offered. In the control group care as usual was offered, but uptake of diagnostics and treatment was not encouraged. Results The response rate was 76%. 31% reported urinary incontinence; of these, 47% was willing to participate. All patients in the intervention group underwent diagnostics and treatment uptake was 80%; in the control group this was 2%.
  
  
  CONCLUSIONS
  To increase treatment uptake, screening must be followed by active encouragement for further diagnostics and treatment. Based on the principles of Wilson and Jungner, female urinary incontinence is a condition suitable for screening. The effect of treatment however needs further evaluation before screening can be recommended. The results of the URINO trial will fill this gap in knowledge.
authors: Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. els.visser@umcg.nl
authors: Els
authors: E
authors: Visser
authors: Janny H
authors: JH
authors: Dekker
authors: Karin M
authors: KM
authors: Vermeulen
authors: Embert J
authors: EJ
authors: Messelink
authors: Aaltje J
authors: AJ
authors: Schram
authors: Marjolein Y
authors: MY
authors: Berger
authors: Geertruida H
authors: GH
authors: de Bock
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000191:economics / Q000379:methods / Q000523:psychology; D008875:Middle Aged; D009426:Netherlands; D010342:Patient Acceptance of Health Care; D017773:Pelvic Floor / Q000503:physiopathology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy