دورية أكاديمية

Effect of pharmacological treatment for urinary incontinence in the elderly and frail elderly: A systematic review.

التفاصيل البيبلوغرافية
العنوان: Effect of pharmacological treatment for urinary incontinence in the elderly and frail elderly: A systematic review.
المؤلفون: Samuelsson, Eva, Odeberg, Jenny, Stenzelius, Karin, Molander, Ulla, Hammarström, Margareta, Franzen, Karin, Andersson, Gunnel, Midlöv, Patrik
المصدر: Geriatrics & Gerontology International; May2015, Vol. 15 Issue 5, p521-534, 14p
مصطلحات موضوعية: RESEARCH methodology evaluation, ELDER care, DRUG therapy, CINAHL database, CONFIDENCE intervals, EXPERIMENTAL design, FRAIL elderly, INFORMATION storage & retrieval systems, MEDICAL databases, MEDICAL information storage & retrieval systems, MEDLINE, META-analysis, NURSING home patients, ONLINE information services, PARASYMPATHOMIMETIC agents, PROBABILITY theory, QUALITY of life, RESEARCH funding, URINARY incontinence, SYSTEMATIC reviews, EVIDENCE-based medicine, CONSTIPATION in old age, PROFESSIONAL practice, TREATMENT effectiveness, RESEARCH bias, DULOXETINE, OXYBUTYNIN (Drug), TOLTERODINE, URINARY urge incontinence, DATA analysis software, DESCRIPTIVE statistics, XEROSTOMIA, EVALUATION, OLD age
مصطلحات جغرافية: SWEDEN
مستخلص: Aim The prevalence and severity of urinary incontinence ( UI) increase with age and comorbidity. The benefits of pharmacotherapy for UI in the elderly are questionable. The aim of the present study was to systematically review the efficacy of pharmacological treatment for UI in the elderly and frail elderly. Methods We searched PubMed, EMBASE, Cochrane library and Cinahl databases through October 2013 to identify prospective controlled trials that evaluated pharmacological treatment for UI in persons aged ≥65 years. Elderly persons living in nursing homes were regarded as frail elderly. Outcomes were urinary leakage, quality of life and adverse events. Results We screened 1038 abstracts and assessed 309 full-text articles. We identified 13 trials of high or moderate quality; 11 evaluated anticholinergic drugs and two evaluated duloxetine. Oxybutynin, the only drug studied in the frail elderly population, had no effect on urinary leakage or quality of life in elderly with urgency UI ( UUI). Seven trials evaluated the effects of darifenacin, fesoterodine, solifenacin, tolterodine or trospium. Urinary leakage decreased (standard mean difference: −0.24, 95% confidence interval −0.32-0.15), corresponding to a reduction of half a leakage per 24 h. Common side-effects of treatment were dry mouth and constipation. Data were insufficient for evaluation of the effect on quality of life or cognition. The evidence was insufficient to evaluate the effects of duloxetine. No eligible studies on mirabegron and estrogen were found. Conclusions Anticholinergics have a small, but significant, effect on urinary leakage in older adults with UUI. Treatment with drugs for UUI in the frail elderly is not evidence based. Geriatr Gerontol Int 2015; 15: 521-534. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:14441586
DOI:10.1111/ggi.12451