The annual cost to UK society attributable to bipolar disorder was estimated to be 2 billion pounds sterling at 1999/2000 prices (estimated 297 000 people with the disorder). Ten per cent of this cost is attributable to NHS resource use, 4% to non-health-care resource use and 86% to indirect costs.
RESULTSOf the respondents, 7.7% reported SUI monthly or more often, and 15% of those had sought help. Help-seekers reported more severe symptoms and greater impact on quality of life. Most (78%) had spoken to their GP, and 77% had received some form of treatment or advice, but only 35% had received recommended treatments. The effects on quality of life were not related to treatment provision.
CONCLUSIONSMost women with SUI are treated in primary care; access to appropriate treatments is poor and may, in part, be the cause of the high levels of unmet need observed in this study. Health education interventions may aid appropriate help-seeking and self-care strategies.
KEYWORDSurinary incontinence, women, quality of life, health behaviour, treatment provision
OBJECTIVETo establish the prevalence of treatmentseeking in women with stress urinary incontinence (SUI), the extent and type of treatment provision, and the levels of unmet need in women who have and have not accessed care, as SUI in women is common but only a small proportion seek help, and there are reports suggesting that few women receive appropriate treatment.
SUBJECTS AND METHODSA cross-sectional postal survey was conducted in which questionnaires were sent to a random sample of community-dwelling women aged ≥ 40 years, registered with
The extent and severity of urinary incontinence amongst women in UK GP waiting rooms. Family Practice 2006; 23: 497-506. Introduction. Few women seek help for urinary incontinence. Subsequently, there may be many women accessing primary care services who would benefit from treatment or advice. If high levels of unexpressed need are present in this population, a more proactive approach to continence management may be appropriate, but the feasibility of this depends on an accurate assessment of the level of unmet need in this population.Aim. To assess the prevalence of urinary incontinence in a female population attending primary care and the extent of treatment seeking in relation to level of need. Methods. A cross-sectional survey of urinary incontinence of adult women attending primary care practices in West Yorkshire, London, Glasgow and Leicestershire during a 10-or 15-day period.Results. Three thousand two hundred and seventy-three (54%) women responded. Twentyone per cent reported stress urinary incontinence only, 3.5% reported urge incontinence only and 21% reported mixed stress and urge incontinence during the preceding month (9% had moderate or severe symptoms). Fifty-three per cent of these had not consulted a health care professional, which is equivalent to 1 in 20 of women in GP waiting rooms, most of whom have stress and urge incontinence (75%) or stress incontinence only (21%).Conclusions. Nearly half of female primary care attendees had experienced incontinence during the preceding month, but only a minority had sought help. Even amongst the nearly 1 in 10 women with moderate or severe incontinence only about half had sought help. There remains considerable health decrement due to urinary incontinence in those not receiving help in a population readily accessible to primary care services.
Records were identified through outpatient clinic lists, surgery lists, nursing and physiotherapy lists. Data were collated and analysed for trends
RESULTSIn all, 412 women (mean age 54.6 years, SD 12.6) covering 1406 visits to secondary care were covered by the study. Most women had a symptomatic diagnosis of mixed UI and mild to moderate UI, as defined by their physician. Most women had conservative therapies by either continence nurses or physiotherapists, regardless of the severity of their condition; 73% had cystometry and 39% were recommended for surgical intervention.
CONCLUSIONSWomen largely undergo similar procedures in secondary care. Most present with mixed UI. The perceived severity of disease did not preclude a trial of conservative therapies.
KEYWORDS incontinence, secondary care, treatment patterns
OBJECTIVESTo describe the treatment trends for women with urinary incontinence (UI) after their referral from primary to secondary care, as despite the high prevalence of UI within the female population, relatively few women actively seek treatment for their UI and fewer reach secondary care.
PATIENTS AND METHODSWe retrospectively reviewed the notes of patients attending in two randomly selected months in five hospital sites in the UK.
Better compliance with inhaled corticosteroids is likely to lead to better asthma control and fewer asthma attacks. Notwithstanding this, increasing compliance is likely to increase primary-care costs. Consequently increasing healthcare expenditure may be the inevitable consequence of improving asthma control.
SR morphine and transdermal fentanyl seem to be used in different situations. The results also confirm previous findings that pain management in cancer patients is often sub-optimal. The low contribution of opioids to the overall costs indicates that this should not be an obstacle to starting this aspect of palliative care earlier in disease progression. This characterisation of the resource implications of using SR morphine and transdermal fentanyl should enable purchasers and providers to optimise the availability of strong opioids for cancer patients on medical, economic and humanitarian grounds.
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