title: Improving the health care of geriatric patients: management of urinary incontinence: a position paper.
abstract: A multidisciplinary German expert group met in 2012 to discuss the current status and prospects of health care of geriatric patients with urinary incontinence in Germany. The purpose of this position paper is to raise awareness among health care providers for the challenges associated with adequate management of urinary incontinence in frail elderly. The experts agree that a multidisciplinary collaboration is essential for the successful treatment of urinary incontinence symptoms which are often associated with loss of autonomy and social isolation. For most geriatric patients, usually the general practitioner is the first contact when seeking help. Hence, the general practitioner plays a crucial role in the coordination of diagnosis and treatment. The involved health care providers should have adequate education and training in their respective disciplines and should be networked allowing quick turnaround times. Non-pharmacological treatments (e.g. behavioural interventions) should have been tried before any pharmacotherapy is initiated. If pharmacological treatment of urinary incontinence involves the use of anticholinergic agents, cognitive performance should be monitored regularly. If indicated, anticholinergic agents with a documented efficacy and safety profile, explicitly assessed in the elderly population, should be preferred.
authors.affiliation: Medizinische Klinik 2 - Geriatrie, Klinikum Nürnberg, Prof.-Ernst-Nathan-Str. 1, 90419, Nürnberg, Germany. klaus.becher@klinikum-nuernberg.de
authors.forename: K
authors.initials: K
authors.lastname: Becher
authors.forename: M
authors.initials: M
authors.lastname: Oelke
authors.forename: B
authors.initials: B
authors.lastname: Grass-Kapanke
authors.forename: J
authors.initials: J
authors.lastname: Flohr
authors.forename: E A
authors.initials: EA
authors.lastname: Mueller
authors.forename: U
authors.initials: U
authors.lastname: Papenkordt
authors.forename: B
authors.initials: B
authors.lastname: Schulte-Frei
authors.forename: K-C
authors.initials: KC
authors.lastname: Steinwachs
authors.forename: S
authors.initials: S
authors.lastname: Süss
authors.forename: M
authors.initials: M
authors.lastname: Wehling
mesh_terms: D000369:Aged, 80 and over; D001521:Behavior Therapy / Q000379:methods*; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods; D005858:Germany; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D058996:Quality Improvement / Q000592:standards*; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000628:therapy*; D014572:Urology / Q000592:standards*
chemical_list: D018680:Cholinergic Antagonists