Developing an internationally-applicable service specification for continence care: systematic review, evidence synthesis and expert consensus.

<h4>Background</h4>Global demographic trends suggest that the incidence of both urinary and faecal incontinence will rise in the coming years, bringing significant health and economic implications for both patients and payers. There is limited organisational evidence to guide payers and...

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Autores principales:	Adrian S Wagg, Diane K Newman, Kai Leichsenring, Paul van Houten
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5e903f5757544ead96d5fd9f80f93312
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spelling	oai:doaj.org-article:5e903f5757544ead96d5fd9f80f933122021-11-25T06:04:47ZDeveloping an internationally-applicable service specification for continence care: systematic review, evidence synthesis and expert consensus.1932-620310.1371/journal.pone.0104129https://doaj.org/article/5e903f5757544ead96d5fd9f80f933122014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25121511/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Global demographic trends suggest that the incidence of both urinary and faecal incontinence will rise in the coming years, bringing significant health and economic implications for both patients and payers. There is limited organisational evidence to guide payers and providers about service configuration which will deliver efficient guideline-compliant, high-quality patient care.<h4>Objectives</h4>To create, using evidence from a systematic review, qualitative data and expert consensus an internationally applicable service specification for continence care.<h4>Method</h4>Evidence was obtained from a systematic and grey literature review of published randomised controlled trials and quasi-experimental studies reporting efficacy of continence service design at the level of the community dwelling patient with either bladder or bowel incontinence, governmental reports and policy frameworks supplemented by data from 47 semi-structured interviews with clinicians, patients, patient-representatives and policy experts from four geographies broadly representative of different healthcare systems.<h4>Results</h4>A number of themes related to current and potential future organisation of continence care were identified from the data. A modular service specification with eight core components was created including case detection, initial assessment and treatment, case co-ordination, caregiver support, community-based support, specialist assessment and treatment, use of containment products, and use of technology. Within this framework important key recommendations are: ensure robust referral pathways, shift assessment for case coordination to nurses specializing in continence care, promote self-management and technology, use comprehensive assessment tools and service performance targets based on outcome and operational measures.<h4>Conclusions</h4>This study has defined practice gaps in the provision of continence services and described eight core components of a service specification for incontinence that commissioners and payers of health and social care could consider using to provide high-quality continence care. A shift towards a community-delivered, nurse-led model appears to be associated with clinical and cost-effective care for people with bladder and bowel incontinence.Adrian S WaggDiane K NewmanKai LeichsenringPaul van HoutenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 8, p e104129 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Adrian S Wagg Diane K Newman Kai Leichsenring Paul van Houten Developing an internationally-applicable service specification for continence care: systematic review, evidence synthesis and expert consensus.
description	<h4>Background</h4>Global demographic trends suggest that the incidence of both urinary and faecal incontinence will rise in the coming years, bringing significant health and economic implications for both patients and payers. There is limited organisational evidence to guide payers and providers about service configuration which will deliver efficient guideline-compliant, high-quality patient care.<h4>Objectives</h4>To create, using evidence from a systematic review, qualitative data and expert consensus an internationally applicable service specification for continence care.<h4>Method</h4>Evidence was obtained from a systematic and grey literature review of published randomised controlled trials and quasi-experimental studies reporting efficacy of continence service design at the level of the community dwelling patient with either bladder or bowel incontinence, governmental reports and policy frameworks supplemented by data from 47 semi-structured interviews with clinicians, patients, patient-representatives and policy experts from four geographies broadly representative of different healthcare systems.<h4>Results</h4>A number of themes related to current and potential future organisation of continence care were identified from the data. A modular service specification with eight core components was created including case detection, initial assessment and treatment, case co-ordination, caregiver support, community-based support, specialist assessment and treatment, use of containment products, and use of technology. Within this framework important key recommendations are: ensure robust referral pathways, shift assessment for case coordination to nurses specializing in continence care, promote self-management and technology, use comprehensive assessment tools and service performance targets based on outcome and operational measures.<h4>Conclusions</h4>This study has defined practice gaps in the provision of continence services and described eight core components of a service specification for incontinence that commissioners and payers of health and social care could consider using to provide high-quality continence care. A shift towards a community-delivered, nurse-led model appears to be associated with clinical and cost-effective care for people with bladder and bowel incontinence.
format	article
author	Adrian S Wagg Diane K Newman Kai Leichsenring Paul van Houten
author_facet	Adrian S Wagg Diane K Newman Kai Leichsenring Paul van Houten
author_sort	Adrian S Wagg
title	Developing an internationally-applicable service specification for continence care: systematic review, evidence synthesis and expert consensus.
title_short	Developing an internationally-applicable service specification for continence care: systematic review, evidence synthesis and expert consensus.
title_full	Developing an internationally-applicable service specification for continence care: systematic review, evidence synthesis and expert consensus.
title_fullStr	Developing an internationally-applicable service specification for continence care: systematic review, evidence synthesis and expert consensus.
title_full_unstemmed	Developing an internationally-applicable service specification for continence care: systematic review, evidence synthesis and expert consensus.
title_sort	developing an internationally-applicable service specification for continence care: systematic review, evidence synthesis and expert consensus.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/5e903f5757544ead96d5fd9f80f93312
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Developing an internationally-applicable service specification for continence care: systematic review, evidence synthesis and expert consensus.

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