Translation of evidence into a self-management tool for use by women with urinary incontinence

Objective: to develop and evaluate an evidence-based self-management urinary incontinence risk factor modification tool for older women. Design: the tool was developed using evidence from a systematic review and input from focus groups. A 6-month prospective cohort study using an interrupted time-series design was conducted to evaluate the tool. Setting: the tool was developed at the University of Toronto and then evaluated at the Universities of Calgary and Montreal, Canada. Subjects: the tool was developed with the help of focus groups of healthcare professionals and of older incontinent women. The tool was evaluated among 103 incontinent women aged 50 years or older. Methods: the tool includes six risk factors with modification strategies. The primary outcome was successful tool usage. Secondary outcomes included urinary leakage, change in self-efficacy and quality of life. Results: the tool was used by 95% [95% confidence interval (CI) 88-98] of women at some point. Urinary leakage rates were reduced by an average of 1.4 daily episodes (95% CI 1.0-1.8). Women reported significant improvement in self-efficacy and incontinence-related quality of life. Conclusions: there appears to be a role for an evidence-based self-management urinary incontinence risk factor modification tool.