First Diagnosis and Management of Incontinence in Older People with and without Dementia in Primary Care: A Cohort Study Using The Health Improvement Network Primary Care Database
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{"title"=>"First Diagnosis and Management of Incontinence in Older People with and without Dementia in Primary Care: A Cohort Study Using The Health Improvement Network Primary Care Database", "type"=>"journal", "authors"=>[{"first_name"=>"Robert L.", "last_name"=>"Grant", "scopus_author_id"=>"54412122900"}, {"first_name"=>"Vari M.", "last_name"=>"Drennan", "scopus_author_id"=>"6603735057"}, {"first_name"=>"Greta", "last_name"=>"Rait", "scopus_author_id"=>"6602151058"}, {"first_name"=>"Irene", "last_name"=>"Petersen", "scopus_author_id"=>"23009891600"}, {"first_name"=>"Steve", "last_name"=>"Iliffe", "scopus_author_id"=>"23050302300"}], "year"=>2013, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491277", "isbn"=>"1549-1676", "pmid"=>"24015113", "scopus"=>"2-s2.0-84883231591", "doi"=>"10.1371/journal.pmed.1001505", "sgr"=>"84883231591", "pui"=>"369700358"}, "id"=>"c26153fa-1cd0-33d0-b9e9-9b5e3c72e2c8", "abstract"=>"BACKGROUND: Dementia is one of the most disabling and burdensome diseases. Incontinence in people with dementia is distressing, adds to carer burden, and influences decisions to relocate people to care homes. Successful and safe management of incontinence in people with dementia presents additional challenges. The aim of this study was to investigate the rates of first diagnosis in primary care of urinary and faecal incontinence among people aged 60-89 with dementia, and the use of medication or indwelling catheters for urinary incontinence.\\n\\nMETHODS AND FINDINGS: We extracted data on 54,816 people aged 60-89 with dementia and an age-gender stratified sample of 205,795 people without dementia from 2001 to 2010 from The Health Improvement Network (THIN), a United Kingdom primary care database. THIN includes data on patients and primary care consultations but does not identify care home residents. Rate ratios were adjusted for age, sex, and co-morbidity using multilevel Poisson regression. The rates of first diagnosis per 1,000 person-years at risk (95% confidence interval) for urinary incontinence in the dementia cohort, among men and women, respectively, were 42.3 (40.9-43.8) and 33.5 (32.6-34.5). In the non-dementia cohort, the rates were 19.8 (19.4-20.3) and 18.6 (18.2-18.9). The rates of first diagnosis for faecal incontinence in the dementia cohort were 11.1 (10.4-11.9) and 10.1 (9.6-10.6). In the non-dementia cohort, the rates were 3.1 (2.9-3.3) and 3.6 (3.5-3.8). The adjusted rate ratio for first diagnosis of urinary incontinence was 3.2 (2.7-3.7) in men and 2.7 (2.3-3.2) in women, and for faecal incontinence was 6.0 (5.1-7.0) in men and 4.5 (3.8-5.2) in women. The adjusted rate ratio for pharmacological treatment of urinary incontinence was 2.2 (1.4-3.7) for both genders, and for indwelling urinary catheters was 1.6 (1.3-1.9) in men and 2.3 (1.9-2.8) in women.\\n\\nCONCLUSIONS: Compared with those without a dementia diagnosis, those with a dementia diagnosis have approximately three times the rate of diagnosis of urinary incontinence, and more than four times the rate of faecal incontinence, in UK primary care. The clinical management of urinary incontinence in people with dementia with medication and particularly the increased use of catheters is concerning and requires further investigation. Please see later in the article for the Editors' Summary.", "link"=>"http://www.mendeley.com/research/first-diagnosis-management-incontinence-older-people-without-dementia-primary-care-cohort-study-usin-7", "reader_count"=>40, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Researcher"=>8, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>3, "Student > Master"=>7, "Other"=>2, "Student > Bachelor"=>4, "Lecturer"=>2, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Researcher"=>8, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>3, "Student > Master"=>7, "Other"=>2, "Student > Bachelor"=>4, "Lecturer"=>2, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>4, "Nursing and Health Professions"=>2, "Mathematics"=>1, "Medicine and Dentistry"=>23, "Agricultural and Biological Sciences"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Psychology"=>4, "Social Sciences"=>3, "Decision Sciences"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>23}, "Social Sciences"=>{"Social Sciences"=>3}, "Decision Sciences"=>{"Decision Sciences"=>1}, "Psychology"=>{"Psychology"=>4}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>4}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "reader_count_by_country"=>{"Canada"=>2, "United States"=>1, "United Kingdom"=>3, "Indonesia"=>1}, "group_count"=>3}

Scopus | Further Information

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Figshare

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  • {"files"=>["https://ndownloader.figshare.com/files/1183366"], "description"=>"<p>Bars indicate 95% confidence intervals.</p>", "links"=>[], "tags"=>["neurology", "dementia", "Primary care", "urology", "incontinence", "men", "women", "compared"], "article_id"=>782984, "categories"=>["Medicine"], "users"=>["Robert L. Grant", "Vari M. Drennan", "Greta Rait", "Irene Petersen", "Steve Iliffe"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001505.g001", "stats"=>{"downloads"=>2, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Rates_of_first_diagnosis_of_incontinence_in_men_and_women_with_dementia_compared_to_those_without_/782984", "title"=>"Rates of first diagnosis of incontinence in men and women with dementia compared to those without.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-08-27 02:25:44"}
  • {"files"=>["https://ndownloader.figshare.com/files/1183374"], "description"=>"<p>Rate ratios, comparing the dementia and non-dementia cohorts.</p>", "links"=>[], "tags"=>["neurology", "dementia", "Primary care", "urology", "comparing", "non-dementia"], "article_id"=>782991, "categories"=>["Medicine"], "users"=>["Robert L. Grant", "Vari M. Drennan", "Greta Rait", "Irene Petersen", "Steve Iliffe"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001505.t002", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Rate_ratios_comparing_the_dementia_and_non_dementia_cohorts_/782991", "title"=>"Rate ratios, comparing the dementia and non-dementia cohorts.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-08-27 02:25:44"}
  • {"files"=>["https://ndownloader.figshare.com/files/1183375"], "description"=>"<div><p>Background</p><p>Dementia is one of the most disabling and burdensome diseases. Incontinence in people with dementia is distressing, adds to carer burden, and influences decisions to relocate people to care homes. Successful and safe management of incontinence in people with dementia presents additional challenges. The aim of this study was to investigate the rates of first diagnosis in primary care of urinary and faecal incontinence among people aged 60–89 with dementia, and the use of medication or indwelling catheters for urinary incontinence.</p><p>Methods and Findings</p><p>We extracted data on 54,816 people aged 60–89 with dementia and an age-gender stratified sample of 205,795 people without dementia from 2001 to 2010 from The Health Improvement Network (THIN), a United Kingdom primary care database. THIN includes data on patients and primary care consultations but does not identify care home residents. Rate ratios were adjusted for age, sex, and co-morbidity using multilevel Poisson regression.</p><p>The rates of first diagnosis per 1,000 person-years at risk (95% confidence interval) for urinary incontinence in the dementia cohort, among men and women, respectively, were 42.3 (40.9–43.8) and 33.5 (32.6–34.5). In the non-dementia cohort, the rates were 19.8 (19.4–20.3) and 18.6 (18.2–18.9). The rates of first diagnosis for faecal incontinence in the dementia cohort were 11.1 (10.4–11.9) and 10.1 (9.6–10.6). In the non-dementia cohort, the rates were 3.1 (2.9–3.3) and 3.6 (3.5–3.8).</p><p>The adjusted rate ratio for first diagnosis of urinary incontinence was 3.2 (2.7–3.7) in men and 2.7 (2.3–3.2) in women, and for faecal incontinence was 6.0 (5.1–7.0) in men and 4.5 (3.8–5.2) in women. The adjusted rate ratio for pharmacological treatment of urinary incontinence was 2.2 (1.4–3.7) for both genders, and for indwelling urinary catheters was 1.6 (1.3–1.9) in men and 2.3 (1.9–2.8) in women.</p><p>Conclusions</p><p>Compared with those without a dementia diagnosis, those with a dementia diagnosis have approximately three times the rate of diagnosis of urinary incontinence, and more than four times the rate of faecal incontinence, in UK primary care. The clinical management of urinary incontinence in people with dementia with medication and particularly the increased use of catheters is concerning and requires further investigation.</p><p><i>Please see later in the article for the Editors' Summary</i></p></div>", "links"=>[], "tags"=>["neurology", "dementia", "Primary care", "urology", "incontinence", "older", "cohort"], "article_id"=>782992, "categories"=>["Medicine"], "users"=>["Robert L. Grant", "Vari M. Drennan", "Greta Rait", "Irene Petersen", "Steve Iliffe"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001505", "stats"=>{"downloads"=>7, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_First_Diagnosis_and_Management_of_Incontinence_in_Older_People_with_and_without_Dementia_in_Primary_Care_A_Cohort_Study_Using_The_Health_Improvement_Network_Primary_Care_Database_/782992", "title"=>"First Diagnosis and Management of Incontinence in Older People with and without Dementia in Primary Care: A Cohort Study Using The Health Improvement Network Primary Care Database", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-08-27 02:25:44"}
  • {"files"=>["https://ndownloader.figshare.com/files/1183373"], "description"=>"<p>IQR, inter-quartile range; N/A, not applicable.</p>", "links"=>[], "tags"=>["neurology", "dementia", "Primary care", "urology"], "article_id"=>782990, "categories"=>["Medicine"], "users"=>["Robert L. Grant", "Vari M. Drennan", "Greta Rait", "Irene Petersen", "Steve Iliffe"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001505.t001", "stats"=>{"downloads"=>9, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_the_cohorts_/782990", "title"=>"Characteristics of the cohorts.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-08-27 02:25:44"}
  • {"files"=>["https://ndownloader.figshare.com/files/1183368"], "description"=>"<p>Bars indicate 95% confidence intervals.</p>", "links"=>[], "tags"=>["neurology", "dementia", "Primary care", "urology", "pharmacological", "urinary", "incontinence", "men", "women", "compared"], "article_id"=>782986, "categories"=>["Medicine"], "users"=>["Robert L. Grant", "Vari M. Drennan", "Greta Rait", "Irene Petersen", "Steve Iliffe"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001505.g002", "stats"=>{"downloads"=>6, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Rates_of_first_use_of_pharmacological_treatment_for_urinary_incontinence_in_men_and_women_with_dementia_compared_to_those_without_/782986", "title"=>"Rates of first use of pharmacological treatment for urinary incontinence in men and women with dementia compared to those without.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-08-27 02:25:44"}

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Relative Metric

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