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April 5, 2024Arthritis Advisory Committee Charter
April 5, 2024TOPLINE:
Use of standardised advice that includes patient information and is guided by general practice/research nurses or healthcare assistants after urinary symptoms assessment appears to provide a small but sustained benefit in terms of men’s lower urinary tract symptoms (LUTS) and quality-of-life outcomes.
METHODOLOGY:
- Researchers conducted a multicentre, pragmatic, two-cluster randomised controlled trial assessing a care pathway based on standardised and manualised care interventions for LUTS in adult men.
- The primary outcome was to determine whether the intervention arm achieved superior symptomatic outcomes vs usual care for male LUTS as measured using overall International Prostate Symptoms Scores (IPSS) at 12 months (with consent) in a primary care setting.
- Participants were men (aged 18 years and older) with bothersome LUTS recruited from 30 National Health System sites in England.
TAKEAWAY:
- Among 1077 male participants, 524 were randomised to the intervention and 553 to usual care.
- At 12 weeks of follow-up, the mean IPSS scores were slightly lower in the intervention arm (mean, 11.60; standard deviation [SD], 6.21) vs usual care (mean, 13.88; SD, 6.84), which suggested that symptoms were worse in the usual care arm (adjusted between-arm difference, −1.81; 95% CI, −2.66 to −0.95; P < .001).
- No between-group differences were observed with regard to the proportion of urinary referrals or adverse events.
- Qualitative interviews demonstrated that the intervention was welcomed, had positive effects on symptoms, understanding of conservative care, and attitude towards LUTS.
IN PRACTICE:
“Self-management guidance is currently insufficiently embedded within primary care consultations,” the authors wrote. They suggested that clinicians should make the intervention guide routinely available within primary care, and highlighted the role that practise nurses and healthcare assistants can play beyond general practitioner consultation.
SOURCE:
The study was led by Jo Worthington, BSc, at the University of Bristol, Bristol, UK, and appeared online in Health Technology Assessment.
LIMITATIONS:
Limitations included a lack of blinding, self-selection bias, and limited ethnic representation.
DISCLOSURES:
The study was funded by the National Institute for Health and Care Research. Jo Worthington reported no conflicts of interests. Several authors reported ties to industry and received speaker fees, sponsorships, and personal fees.