HTA-funded Research Tests Incontinence Products, UK

Main Category: Urology / Nephrology
Article Date: 14 Nov 2008 - 4:00 PST

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Research published by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme suggests that allowing users of incontinence pads to choose combinations of designs for different circumstances would be clinically and cost-effective. The NHS, nursing homes and public spend around £94 million per year on incontinence pads. However, the research base for making informed choices between different product designs is very weak.

The study led by Dr Mandy Fader of the University of Southampton compared the cost-effectiveness of the key product design groups in three clinical trials. Trial one recruited 85 women with light urinary incontinence living in the community; trial 2a looked at 85 moderate / heavily incontinent adults living in the community; and trial 2b involved 100 moderate / heavily incontinent adults living in nursing homes. Researchers measured product performance (e.g. leakage and discreetness), acceptability and participants' preferences, for the different designs.

The research team found that for light incontinence disposable inserts were the most effective design out of the four tested in trial one. However, some women preferred menstrual pads or washable pants, which were both cheaper. For moderate / heavily incontinent adults both trial 2a and 2b found that disposable pull-ups were the most effective and acceptable for women, and for men disposable diapers were better overall and the most cost-effective design.

"Our research showed that the performance and acceptability of designs varied between users and allowing them to choose combinations of designs for different circumstances within a budget may offer the best solution," says Dr Fader. "The results of this trial will help provide a more solid basis for guiding selection and purchase of incontinence pads."

Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs has been published in Health Technol Assess 2008; Vol.12:29. To view the full results visit http://www.hta.ac.uk/1303

1. Trial one tested four design categories available (total of 12 test products): disposable inserts (pads); menstrual pads; washable pants with integral pad; and washable inserts.

2. Trial 2a tested three (or two) products from each of the five design categories available (total of 14 test products): disposable inserts (with mesh pants); disposable diapers (nappies); disposable pull-ups (similar to toddlers' trainer pants); disposable T-shaped diapers (nappies with waist-band); and washable diapers. All products were provided in a daytime and a (mostly more absorbent) night-time variant.

3. Trial 2b participants evaluated one product from each of the four disposable design categories from Trial 2a. Products were selected on the basis of product performance in Trial 2a and daytime and night-time variants were provided.

4. The HTA programme is a programme of the National Institute for Health Research (NIHR) and produces high quality research information about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest of the NIHR programmes and publishes the results of its research in the Health Technology Assessment journal, with over 440 issues published to date. The journal's 2007 Impact Factor (3.87) ranked it in the top 10% of medical and health-related journals. All issues are available for download free of charge from the website, http://www.hta.ac.uk The HTA programme is coordinated by the NIHR Coordinating Centre for Health Technology Assessment (NCCHTA), based at the University of Southampton.

5. The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients.

National Institute for Health Research