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EFFECTIVENESS OF DIAPERS AMONG PEOPLE WITH CHRONIC INCONTINENCE IN THAILAND

Published online by Cambridge University Press:  22 July 2015

Yot Teerawattananon
Affiliation:
Health Intervention and Technology Assessment Program, Ministry of Public Health
Thunyarat Anothaisintawee
Affiliation:
Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol Universitythunyarat.ano@mahidol.ac.th
Sripen Tantivess
Affiliation:
Health Intervention and Technology Assessment Program, Ministry of Public Health
Ubonwan Wattanadilokkul
Affiliation:
Sirindhorn National Medical Rehabilitation Center, Department of medical Services, Ministry of Public Health
Pranorn Krajaisri
Affiliation:
Sirindhorn National Medical Rehabilitation Center, Department of medical Services, Ministry of Public Health
Sudarat Yotphumee
Affiliation:
Sirindhorn National Medical Rehabilitation Center, Department of medical Services, Ministry of Public Health
Jaraspas Wongviseskarn
Affiliation:
Department of Physical Medicine and Rehabilitation, Phramongkutklao College of Medicine
Utsana Tonmukayakul
Affiliation:
Health Intervention and Technology Assessment Program, Ministry of Public Health
Roongnapa Khampang
Affiliation:
Health Intervention and Technology Assessment Program, Ministry of Public Health

Abstract

Objectives: The aim of this study was to assess effect of adult diapers on health-related quality of life (HRQOL) and the independent level of performing activities of daily living (ADLs) in people with urinary or fecal incontinence. Psychological consequences of patients’ caregivers were also measured.

Methods: This quasi-experimental study was conducted at two rehabilitation centers in Thailand. People aged 15 years or greater with chronic urinary or fecal incontinence were eligible. Study participants received adult diapers for 10 weeks after recruitment. Thai EuroQol Five Dimensions (EQ-5D) and the Barthel Index were measured at baseline and weeks 2, 6, and 10 to evaluate HRQOL and the independent level of performing ADLs, respectively. The Braden Scale was used to assess the risk of having pressure ulcers. Mean differences in the Thai EQ-5D, the Barthel Index, and the Braden Scale, before and after receiving adult diapers, were estimated using a multilevel linear regression model.

Results: There were ninety patients and forty-eight caregivers who took part in this study. HRQOL and independent level of performing ADLs had improved significantly by week 10 after receiving adult diapers with mean differences of 0.102 (95% confidence interval [CI], 0.046–0.158) and 4.40 (95% CI, 1.74–7.07), respectively. The risk of having pressure ulcers had significantly decreased by 67 percent (95% CI, 16 percent–78 percent) by week 10 after receiving adult diapers.

Conclusions: The results indicate a significant improvement of HRQOL and the independent level of performing ADLs among incontinent patients after receiving adult diapers. These results were used to inform the development of the health benefits package under the Universal Health Coverage Scheme in Thailand.

Type
Assessments
Copyright
Copyright © Cambridge University Press 2015 

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References

REFERENCES

1. Coyne, KS, Zhou, Z, Thompson, C, Versi, E. The impact on health-related quality of life of stress, urge and mixed urinary incontinence. BJU Int. 2003;92:731735.Google Scholar
2. Grimby, A, Milsom, I, Molander, U, Wiklund, I, Ekelund, P. The influence of urinary incontinence on the quality of life of elderly women. Age Ageing. 1993;22:8289.Google Scholar
3. Milsom, I, Coyne, KS, Nicholson, S, Kvasz, M, Chen, CI, Wein, AJ. Global prevalence and economic burden of urgency urinary incontinence: A systematic review. Eur Urol. 2014;65:7995.Google Scholar
4. Whitehead, WE, Borrud, L, Goode, PS, et al. Fecal incontinence in US adults: Epidemiology and risk factors. Gastroenterology. 2009;137:512517, 517.e1–2.Google Scholar
5. Chiarelli, P, Bower, W, Wilson, A, Attia, J, Sibbritt, D. Estimating the prevalence of urinary and faecal incontinence in Australia: Systematic review. Australas J Ageing. 2005;24:1927.Google Scholar
6. Cameron, AP, Jimbo, M, Heidelbaugh, JJ. Diagnosis and office-based treatment of urinary incontinence in adults. Part two: Treatment. Ther Adv Urol. 2013;5:189200.Google Scholar
7. Fader, M, Bliss, D, Cottenden, A, Moore, K, Norton, C. Continence products: Research priorities to improve the lives of people with urinary and/or fecal leakage. Neurourol Urodyn. 2010;29:640644.Google Scholar
8. Hu, TW, Wagner, TH, Bentkover, JD, et al. Costs of urinary incontinence and overactive bladder in the United States: A comparative study. Urology. 2004;63:461465.Google Scholar
9. Wilson, L, Brown, JS, Shin, GP, Luc, KO, Subak, LL. Annual direct cost of urinary incontinence. Obstet Gynecol. 2001;98:398406.Google Scholar
10. Fader, M, Cottenden, AM, Getliffe, K. Absorbent products for moderate-heavy urinary and/or faecal incontinence in women and men. Cochrane Database Syst Rev. 2008:CD007408.Google Scholar
11. Cottenden, A, Petterson, L. How well does ISO 11984–1 (the Rothwell method) for measuring the absorption capacity of incontinence pads in the laboratory correlate with clinical pad performance. J Med Eng Phys. 2003;25:603613.CrossRefGoogle Scholar
12. Teerawattananon, Y, Chaikledkaew, U. Thai health technology assessment guideline development. J Med Assoc Thai. 2008;91 (Suppl 2):S11S15.Google Scholar
13. Tongsiri, S, Cairns, J. Estimating population-based values for EQ-5D health states in Thailand. Value Health. 2011;14:11421145.Google Scholar
14. Mahoney, F, Barthel, D. Functional evaluation: The Barthel Index. Md Med J. 1965;14:6165.Google Scholar
15. Bergstrom, N, Braden, BJ, Laguzza, A, Holman, V. The Braden Scale for Predicting Pressure Sore Risk. Nurs Res. 1987;36:205210.CrossRefGoogle ScholarPubMed
16. Langa, KM, Fultz, NH, Saint, S, Kabeto, MU, Herzog, AR. Informal caregiving time and costs for urinary incontinence in older individuals in the United States. J Am Geriatr Soc. 2002;50:733737.Google Scholar
17. Gotoh, M, Matsukawa, Y, Yoshikawa, Y, et al. Impact of urinary incontinence on the psychological burden of family caregivers. Neurourol Urodyn. 2009;28:492496.Google Scholar
18. Zigmond, AS, Snaith, RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361370.Google Scholar
19. Pickard, AS, Neary, MP, Cella, D. Estimation of minimally important differences in EQ-5D utility and VAS scores in cancer. Health Qual Life Outcomes. 2007;5:70.Google Scholar
20. Luo, N, Johnson, J, Coons, SJ. Using instrument-defined health state transitions to estimate minimally important differences for four preference-based health-related quality of life instruments. Med Care. 2010;48:365371.Google Scholar
21. Kohn, CG, Sidovar, MF, Kaur, K, Zhu, Y, Coleman, CI. Estimating a minimal clinically important difference for the EuroQol 5-Dimension health status index in persons with multiple sclerosis. Health Qual Life Outcomes. 2014;12:66.Google Scholar
22. Craig, AR, Hancock, KM, Dickson, HG. A longitudinal investigation into anxiety and depression in the first 2 years following a spinal cord injury. Paraplegia. 1994;32:675679.Google Scholar
23. Kennedy, P, Rogers, BA. Anxiety and depression after spinal cord injury: A longitudinal analysis. Arch Phys Med Rehabil. 2000;81:932937.CrossRefGoogle ScholarPubMed
24. Pollard, C, Kennedy, P. A longitudinal analysis of emotional impact, coping strategies and post-traumatic psychological growth following spinal cord injury: A 10-year review. Br J Health Psychol. 2007;12 (pt 3):347362.Google Scholar
25. Tantivess, S, Perez Velasco, R, Yothasamut, J, et al. Efficiency or equity: Value judgments in coverage decisions in Thailand. J Health Organ Manag. 2012;26:331342.Google Scholar
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