Urinary Incontinence Epidemiology and Care Seeking

尿失禁流行病学和就医

基本信息

批准号：
9276671
负责人：
FRANCINE GRODSTEIN
金额：
$ 42.59万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-06-01 至 2019-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9276671
关键词：
Absorbent Pads Address Age Awareness Caring Characteristics Clinical Communities Comorbidity Complement Data Emotional Epidemiologist Epidemiology Etiology Evaluation Frequencies Goals Guidelines Health Health Personnel Healthcare Incidence Individual Joints Knowledge Lead Learning Link Medical Medicare Medicare claim Minority Natural History Nurses Nurses&apos Health Study Operative Surgical Procedures Participant Patient Self-Report Patients Pharmacologic Substance Physical therapy Prevalence Prevention Provider Public Health Quality of life Questionnaires Research Research Personnel Risk Factors Severities Stress Stress Urinary Incontinence Symptoms Time Training Treatment outcome Urinary Incontinence Woman aged care seeking clinically relevant cost health care service utilization health related quality of life improved incontinence symptom micturition urgency middle age multidisciplinary older patient older women patient population prevent prospective public health relevance stress management young woman

Absorbent Pads Address Age Awareness Caring Characteristics Clinical Communities Comorbidity Complement Data Emotional Epidemiologist Epidemiology Etiology Evaluation Frequencies Goals Guidelines Health Health Personnel Healthcare Incidence Individual Joints Knowledge Lead Learning Link Medical Medicare Medicare claim Minority Natural History Nurses Nurses&apos Health Study Operative Surgical Procedures Participant Patient Self-Report Patients Pharmacologic Substance Physical therapy Prevalence Prevention Provider Public Health Quality of life Questionnaires Research Research Personnel Risk Factors Severities Stress Stress Urinary Incontinence Symptoms Time Training Treatment outcome Urinary Incontinence Woman aged care seeking clinically relevant cost health care service utilization health related quality of life improved incontinence symptom micturition urgency middle age multidisciplinary older patient older women patient population prevent prospective public health relevance stress management young woman

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项目摘要

DESCRIPTION (provided by applicant): Urinary incontinence (UI) is a physically, emotionally, and economically burdensome condition that is common among women of all ages. Yet, only a minority of women, even those with severe symptoms, discusses UI with their healthcare provider. The goal of this project is to provide data to inform decisions about UI care seeking and management, with the long-term aim of reducing UI burden. Our specific aims leverage detailed data on UI over up to 16 years among >140,000 women, aged 37-91 years, in the Nurses' Health Studies (NHS, NHSII). The first aim addresses the lack of data tracking UI natural history; improved knowledge of natural history will help facilitate discussions between women and clinicians about the expected course of UI symptoms and timing of prevention or management. We will track changes in UI frequency, severity, and subtype, collected via questionnaires administered every 2 to 4 years, over up to 16 years. Separate analyses will consider natural history within older and younger women. The second aim of this project is to evaluate potential determinants of care seeking for UI, which could help providers target and inform women who do not discuss their symptoms. We will specifically evaluate relations of UI characteristics (e.g., higher severity, more bother, mixed UI subtype, longer duration) and independent health factors (e.g., more co-morbidity, worse health- related quality of life) with self-reported discussions about UI with healthcare providers. In complement, we will also evaluate relations of potential determinants with UI identification by providers utilizing linked Medicare and NHS data. Finally, information on treatment likelihood, or on how different UI subtypes are treated, has not been possible to determine, since it requires joint knowledge of UI, UI characteristics, and treatments utilized. Thus, in the third aim we will leverage linked NHS and Medicare claims data to examine utilization of medical and surgical treatments for UI, including which patients receive (and don't receive) treatment, and how UI subtypes are treated. These data could help identify patients who might benefit from treatment discussions and help inform providers on treatment guidelines. Overall, the three aims of this proposal have direct clinical relevance to optimizing care for UI and reducing its burden.

描述（由适用提供）：尿失禁（UI）是一种身体，情感和经济繁重的状况，在各个年龄段的女性中都是常见的。然而，只有少数妇女，甚至有严重症状的妇女，都与她们的医疗保健提供者讨论了UI。该项目的目的是提供数据，以减少UI Burnen的长期目的为UI护理寻求和管理的决策提供信息。我们的具体目的是在护士健康研究（NHS，NHSII）中，在> 14万名37-91岁的妇女中利用了16年的UI详细数据。第一个目的解决了缺乏跟踪UI自然历史的数据；对自然历史的知识的提高将有助于促进妇女与临床医生在预期的UI症状和预防或管理时机之间进行讨论。我们将跟踪收集的UI频率，严重性和亚型的变化。通过问卷调查每2至4年一次管理，多达16年。单独的分析将考虑年龄较大和年轻妇女的自然历史。该项目的第二个目的是评估潜在的确定UI的护理，这可以帮助提供者针对并告知不讨论其症状的妇女。我们将专门评估UI特征的关系（例如，更高的严重程度，更高的UI亚型，更长的持续时间）和独立的健康因素（例如，更多的合并症，与健康相关的生活质量较差）以及与医疗保健提供者有关UI的讨论。完成后，我们还将通过利用链接的Medicare和NHS数据的提供商来评估潜在的确定词与UI识别的关系。最后，无法确定有关治疗可能性或如何处理UI亚型的信息，因为它需要使用UI，UI特征和使用的治疗方法的联合知识。在第三个目标中，我们将利用链接的NHS Medicare索赔数据以检查对UI的医学和外科手术治疗的利用，包括患者接受（并且不接受）治疗以及如何治疗UI亚型。这些数据可以帮助确定可能从治疗讨论中受益的患者，并帮助提供者了解治疗指南。总体而言，该提案的三个目标具有直接的临床相关性，可以优化对UI的护理和减少其伯恩。