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Qualitative assessment of the conservative management of nocturia with standardised written materials for Lower Urinary Tract Symptoms in men treated in primary care

Olaniyi, Patrick; Cotterill, Nikki; Drake, Marcus J; Frost, Jessica; Lane, J Athene; Ridd, Matthew; Robles, Luke; Taylor, Gordon; Worthington, Jo; Wheeler, Jessica

Authors

Patrick Olaniyi

N Nikki Cotterill Nikki.Cotterill@uwe.ac.uk
Professor of Long Term Conditions (Continence Care)

Marcus J Drake

Jessica Frost

J Athene Lane

Matthew Ridd

Luke Robles

Gordon Taylor

Jo Worthington

Jessica Wheeler



Abstract

Context, Many men prefer conservative treatment of lower urinary tract symptoms (LUTS), but education and self-help guidance is limited in primary care

Objective, To report qualitative interview findings for men reporting nocturia in a primary care presentation for LUTS

Evidence Acquisition, TRIUMPH is a cluster randomised trial of standardised/ manualised care (a healthcare professional delivered booklet) vs. usual care for prevalent LUTS in primary care. The qualitative component included 58 early-stage and 33 late-stage participant interviews, assessing experience of LUTS and conservative treatment in primary care.

Evidence Synthesis, Nocturia is a common driver for seeking healthcare, perceived by men as relatively acceptable to discuss. Information and self-help guidance were largely absent from descriptions of GP consultations, other than reducing evening caffeine/ fluid intake. The TRIUMPH LUTS intervention booklet offered explanations and self-management guidance. Men with long-term disruptive symptoms, perceptions the booklet content was novel/ worthwhile, and belief that self-management might help were more receptive. In follow-up, improved nocturia was related to successful implementation of several aspects of the guidance. Most men were willing to do a bladder diary, but some found it inconvenient, especially men in employment.

Conclusion, Reassuring men that nocturia is part of ageing, without offering information and support, risks reinforcing tendencies to discount problematic LUTS. The trial booklet and healthcare professional training supports nocturia self-management guidance, which is most effective for men receptive to this approach. However, the nature of the trial population means the findings may not apply to all men.

Patient Summary, Men are more comfortable discussing waking at night to urinate than other urinary symptoms with their GP. This problem should lead to detailed discussion of all urinary symptoms, rather than being thought of as a sign of ageing. The study information booklet and nurse consultation helped many men to improve this problem.

Citation

Olaniyi, P., Cotterill, N., Drake, M. J., Frost, J., Lane, J. A., Ridd, M., …Wheeler, J. (in press). Qualitative assessment of the conservative management of nocturia with standardised written materials for Lower Urinary Tract Symptoms in men treated in primary care. European Urology Focus, https://doi.org/10.1016/j.euf.2022.01.003

Journal Article Type Article
Acceptance Date Dec 28, 2021
Online Publication Date Jan 13, 2022
Deposit Date Jan 14, 2022
Publicly Available Date Jan 14, 2023
Publisher Elsevier
Peer Reviewed Peer Reviewed
DOI https://doi.org/10.1016/j.euf.2022.01.003
Public URL https://uwe-repository.worktribe.com/output/8566996