A randomised partially controlled trial to assess the impact of self-help vs. structured help from a continence nurse specialist in women with undiagnosed urinary problems in primary care

AIMS: To identify women in primary care aged 45-64 years with urinary problems using the Female Urinary Symptom Score (FUSS) assessment tool, and to compare the effectiveness of a self-help leaflet with structured help from a continence nurse. METHODS: The women were sent a questionnaire and grouped according to FUSS score as mild moderate or severe. The mild group received no intervention. The moderate group was randomised into three: one received no intervention, one receiving a self-help leaflet and one receiving an offer of structured help. The severe group was randomised into two: structured help at a continence clinic or a self-help leaflet. The women were followed up on two occasions to assess effects of the interventions. RESULTS: A total of 1175 women participated in the study and were categorised at baseline into mild (n = 764), moderate (n = 325) or severe (n = 86). Response rates to initial follow-up varied from 50% to 86% across the study. Intervention groups reported significant reduction in mean FUSS score ranging from 1.2 points (moderate leaflet group) to 7.8 points (severe structured help group). The two non-intervention groups reported low levels of FUSS change (mild + 0.7 and moderate non-intervention -0.4). There was a strong association between quality of life (QoL) and FUSS score, with improvement in QoL when FUSS score fell. At follow-up improvement was sustained. CONCLUSION: The trial has shown that the FUSS questionnaire has potential for identifying women with bothersome urinary symptoms and can be utilised in primary care. Both leaflet and structured help were effective