Health-related quality of life and economic impact of urinary incontinence due to detrusor overactivity associated with a neurologic condition: a systematic review

Health and Quality of Life Outcomes, 2013 · DOI: 10.1186/1477-7525-11-13 · Published: January 31, 2013

Simple Explanation

Patients with neurologic diseases often experience a loss of bladder control, leading to uncontrollable urinary incontinence (UI). This review examines the impact of UI due to neurogenic detrusor overactivity (NDO) on patients' quality of life and the economic burden in North America, the European Union, Asia, and Australia. The review found that UI due to NDO negatively affects the health-related quality of life (HRQoL) of patients with neurological conditions such as multiple sclerosis, spinal cord injury, Parkinson's disease, and stroke. The review also indicates that urgency UI results in substantial economic costs, including direct medical costs, costs for conservative care, physician/hospital/emergency room services, medication, and complications.

Study Duration

January 2000 to February 2011

Participants

Not specified

Evidence Level

Systematic Review

Key Findings

1
UI in individuals with MS, SCI, Parkinson’s disease, and stroke has a substantial negative impact on patients’ HRQoL, affecting physical function, emotional well-being, and social relationships.
2
Incontinent individuals with underlying neurologic conditions typically report worse HRQoL compared with their continent counterparts and the general population.
3
The economic burden of UI due to NDO is substantial for patients, providers, and payers, including direct medical costs, costs for conservative care, physician/hospital/emergency room services, medication and complications.

Research Summary

This systematic review assessed the health-related quality of life (HRQoL) and economic burden in patients with urgency urinary incontinence (UI) due to neurogenic detrusor overactivity (NDO) in select countries. The review found that UI due to NDO negatively impacts HRQoL in patients with neurologic conditions and results in significant economic costs. The authors conclude that there is a need for urgency UI treatments that improve HRQoL and alleviate the economic burden of this condition.

Practical Implications

Improved Treatment Strategies

Develop and implement urgency UI treatments that focus on improving the HRQoL of patients with underlying neurological conditions.

Economic Considerations

Address the substantial economic burden associated with UI due to NDO by developing cost-effective management strategies.

Standardized HRQoL Assessments

Establish consensus on standardized tools to assess HRQoL in patients with neurologic diseases to facilitate comparisons across studies and improve research outcomes.

Study Limitations

1
Inconsistent terminology used across the literature to describe patients with UI due to NDO.
2
Lack of relevant studies in patients with UI due to urodynamically confirmed NDO.
3
Economic burden assessments were largely conducted in the general UI population, not specifically in patients with MS, SCI, Parkinson’s disease, stroke, or spina bifida.

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