Effectiveness of non-pharmacological interventions delivered at home for urinary and faecal incontinence with homebound older people: Systematic review of randomised controlled trials

Buck, Jackie ORCID: https://orcid.org/0000-0002-3598-2329, Fromings Hill, Julia, Collins, Rachael, Booth, Joanne and Fleming, Jane (2024) Effectiveness of non-pharmacological interventions delivered at home for urinary and faecal incontinence with homebound older people: Systematic review of randomised controlled trials. Age and Ageing, 53 (6). ISSN 0002-0729

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Abstract

Introduction: Incontinence is a common, distressing condition, most prevalent in older people. There is an unmet need for effective interventions to support continence. This review focuses on non-pharmacological interventions to reduce incontinence among homebound older people. Aim: to identify interventions with potential to be delivered by care workers, nurses or family members in a person's home. Methods: Multiple databases were searched until 15 September 2023 for randomised controlled trials reporting home-based interventions for incontinence for older people (≥65 years) living at home. Two reviewers independently screened titles, abstracts and papers against inclusion criteria, then assessed for the Risk of Bias (RoB2). A third reviewer resolved the discrepancies. Primary data were extracted and synthesised. Results: A full-text review of 81 papers identified seven eligible papers (1996-2022, all USA), including n = 636 participants (561 women and 75 men). Two studies focusing on multicomponent behavioural interventions showed benefit, as did one study of transcutaneous tibial nerve stimulation self-administered through electrode-embedded socks. Three, which included cognitively impaired people, reported improvement with toileting assistance programmes, but the effects were not all significant. Results were inconclusive from a study examining the effects of fluid intake adjustments. Interventions were delivered by nurses, three in collaboration with family caregivers. No faecal incontinence interventions met the criteria. Conclusion: There is scant evidence for continence supporting interventions delivered in older people's own homes. With an ageing population often reliant on family or social care workers well-placed to support continence promotion and policy drives for services to support older people remaining at home, this evidence gap needs addressing.

Item Type: Article
Additional Information: Funding Information: This study was supported by research funding from The General Nursing Council for England and Wales Trust [Reg. No: 288068].
Uncontrolled Keywords: faecal incontinence,homebound,older people,systematic review,urinary incontinence,ageing,geriatrics and gerontology ,/dk/atira/pure/subjectarea/asjc/1300/1302
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Health Promotion
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 07 Aug 2024 16:30
Last Modified: 07 Aug 2024 16:30
URI: https://ueaeprints.uea.ac.uk/id/eprint/96175
DOI: 10.1093/ageing/afae126

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