A Feasibility Study for a Posthospital Intervention for Lower Urinary Tract Symptoms in Adults With Heart Failure.
OBJECTIVE
To test the feasibility of a self-management intervention for lower urinary tract symptoms (LUTS) in adults with heart failure (HF) discharged from hospital.


METHODS
Single blinded randomized controlled trial.


METHODS
Thirty-one adults, aged 50 years and older, with an HF diagnosis and 1 or more LUTS were recruited during their hospitalization after passing a cognitive screen. Subjects received the intervention and completed postintervention measures in their own homes.


METHODS
During hospitalization, subjects were recruited, enrolled, and consented, and then completed baseline questionnaires and 24-hour pad test. After discharge, both groups received educational sessions on different topics by telephone in 4-weekly sessions. The specific aims were to determine: (1) subject recruitment and retention rates, (2) subjects' adherence to baseline and postintervention measures, and (3) subjects' and nurse interventionist's adherence to the protocol. The LUTS intervention effects on specific clinical outcomes were explored.


RESULTS
Potential subjects were recruited over 5 months at an enrollment ratio of 4.7:1. Approximately 68% completed the study. Average age was 66.3 ± 9.8 years (mean ± SD). The majority were female (54.8%) and white (51.6%). Most subjects had urinary incontinence (UI) (74.2%) and 77.4% rated their health as either fair or poor. The study was underpowered to determine statistical significance at P < .05 level. Thirty-three percent of the LUTS intervention group reported improved UI frequency postintervention, compared to 25% of the attention control group.


CONCLUSIONS
Adults with HF experience LUTS, but little is known about how best to manage and treat it. This study showed that it is possible to recruit and retain adults who have HF and rate their health as fair or poor into a 4-week intervention study, although oversampling is needed due to attrition.
Mary H. Palmer, PhD, RN,C, FAAN, AGSF, School of Nursing, University of North Carolina at Chapel Hill. Celine Siewe Marquez, BSN, RN, School of Nursing, University of North Carolina at Chapel Hill. Yin Li, RN, BM, School of Nursing, University of North Carolina at Chapel Hill. Shelley Yerger Hawkins, DSN, FNP-BC, GNP, FAANP, Hahn School of Nursing & Health Science, University of San Diego, San Diego, California. Fay Smith, RN, MSN, FNP, School of Medicine, University of North Carolina at Chapel Hill. Jan Busby-Whitehead, MD, CMD, AGSF, Division of Geriatric Medicine, Department of Medicine, and Center for Aging and Health, School of Medicine, University of North Carolina at Chapel Hill.
Mary H
MH
Palmer
Celine Siewe
CS
Marquez
Yin
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Li
Shelley Yerger
SY
Hawkins
Fay
F
Smith
Jan
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Busby-Whitehead
D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000517:prevention & control / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011788:Quality of Life; D012648:Self Care; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*; D014549:Urinary Incontinence / Q000523:psychology / Q000628:therapy