title: Active encouragement of older women with urinary incontinence in primary care to undergo diagnosis and treatment: a matched-pair cluster randomized controlled trial.
abstract: OBJECTIVE
  The URINO trial investigated the effect of offering treatment to older women with urinary incontinence in the general population, who had not sought help on their own initiative.
  
  
  METHODS
  In a cluster randomized trial, 14 general practitioners were matched into pairs and randomly allocated to an intervention or a control group. Women aged ≥ 55 years registered in the participating practices were asked about urinary incontinence via a postal questionnaire. Patients in the intervention group were assessed and treated whereas patients in the control group received standard care.
  
  
  METHODS
  Primary outcome was improvement (yes or no) of the severity of symptoms at 12-month follow-up measured with the Incontinence Severity Index. Secondary outcomes were the number of incontinence episodes per day and quality of life. The primary analysis was on an intention-to-treat basis with multiple imputation of missing data. A logistic regression model with correction for cluster randomization was fitted to estimate odds ratios (ORs).
  
  
  RESULTS
  At 12 months, the severity of symptoms had improved in more patients in the intervention group (n166) than in the controls (n184) (OR 1.9; 95% CI 1.1-3.3). Also, the number of patients with fewer episodes of incontinence had increased (OR 2.5; 95% CI 1.5-4.1). No between-group differences in changes in quality of life were apparent (p0.14).
  
  
  CONCLUSIONS
  It is recommended to encourage women in the general population aged ≥ 55 years with urinary incontinence to undergo diagnosis and treatment.
authors.affiliation: Department of General Practice, University of Groningen, University Medical Centre Groningen, PO Box 196, 9700 AD Groningen, The Netherlands. Electronic address: els.visser@umcg.nl.
authors.forename: Els
authors.initials: E
authors.lastname: Visser
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Centre Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: g.h.de.bock@umcg.nl.
authors.forename: Geertruida H
authors.initials: GH
authors.lastname: de Bock
authors.affiliation: Department of Urology, University of Groningen, University Medical Centre Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: e.j.messelink@umcg.nl.
authors.forename: Embert J
authors.initials: EJ
authors.lastname: Messelink
authors.affiliation: Department of Gynaecology, University of Groningen, University Medical Centre Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: a.j.schram@umcg.bnl.
authors.forename: Aaltje J
authors.initials: AJ
authors.lastname: Schram
authors.affiliation: Department of General Practice, University of Groningen, University Medical Centre Groningen, PO Box 196, 9700 AD Groningen, The Netherlands. Electronic address: b.j.kollen@umcg.nl.
authors.forename: Boudewijn J
authors.initials: BJ
authors.lastname: Kollen
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Centre Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: s.la.bastide@umcg.nl.
authors.forename: Sacha
authors.initials: S
authors.lastname: la Bastide-van Gemert
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Centre Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: e.r.van.den.heuvel@umcg.nl.
authors.forename: Edwin R
authors.initials: ER
authors.lastname: van den Heuvel
authors.affiliation: Department of General Practice, University of Groningen, University Medical Centre Groningen, PO Box 196, 9700 AD Groningen, The Netherlands. Electronic address: m.y.berger@umcg.nl.
authors.forename: Marjolein Y
authors.initials: MY
authors.lastname: Berger
authors.affiliation: Department of General Practice, University of Groningen, University Medical Centre Groningen, PO Box 196, 9700 AD Groningen, The Netherlands. Electronic address: j.h.dekker@umcg.nl.
authors.forename: Janny H
authors.initials: JH
authors.lastname: Dekker
mesh_terms: D000368:Aged; D037001:Directive Counseling; D005260:Female; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D011788:Quality of Life; D011795:Surveys and Questionnaires; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000628:therapy*; D014549:Urinary Incontinence / Q000175:diagnosis / Q000628:therapy*
keywords: Aged; Female; General practice; Urinary incontinence