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Age and Ageing 2008 37(4):379-383; doi:10.1093/ageing/afn108
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Copyright © The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society.

Rating improvements in urinary incontinence: do patients and their physicians agree?

Cara Tannenbaum1,2, Judith Brouillette2 and Jacques Corcos3

1 Department of Geriatric Medicine, Institut universitaire de gériatrie de Montreal, Montreal, Quebec H3 W1 W5, Canada
2 Department of Medicine, Université de Montréal, Montreal, Canada
3 Department of Urology, Jewish General Hospital, Montreal, Canada

Address correspondence to: C. Tannenbaum. Department of Geriatric Medicine, Institut universitaire de gériatrie de Montreal, Montreal, Quebec H3 W1 W5, Canada. Tel: 514-340-3540; ext. 2526; Fax: 514-340-3530. Email: cara.tannenbaum{at}umontreal.ca

Objective: to determine whether patients' perceptions of improvement following behavioural interventions for urinary incontinence (UI) correspond with physicians' global ratings of change, and to compare both these ratings with more objective UI outcome measures.

Methods: consecutive new female patients aged 65 years and older recruited from outpatient UI clinics in Quebec received a behavioural management protocol for UI. At 3-month follow-up, patients and physicians were independently asked for their global impression of change in UI status. Patients completed 3-day voiding diaries and a UI-specific quality-of-life index before and after treatment.

Results: 108 patients (mean age 73 ± 5 years, range 65-86 years) with stress, urge and mixed UI participated. There was concordance between patients' and physicians' ratings of change in 57% of cases. Among the remaining cases, patients were 1.6 times as likely to report significant improvements compared to physicians. Patients' ratings correlated more strongly with improvements in UI episodes in the voiding diary (r = 0.4, P = 0.002 versus r = 0.3, P = 0.004 for physicians) and on the quality-of-life index (r = –0.5, P < 0.0001 versus r = –0.4, P < 0.0001 for physicians).

Conclusion: physicians underestimate clinically meaningful changes in UI in older women following behavioural interventions.

Keywords: urinary incontinence, outcome measures, behavioural interventions, elderly

Received 29 August 2007; accepted in revised form 17 January 2008.


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