Identifying continence options after stroke (ICONS): a cluster randomised controlled feasibility trial

LH Thomas, CL Watkins, CJ Sutton, D Forshaw, MJ Leathley, B French, CR Burton, F Cheater, Brenda Roe, D Britt, J Booth, E McColl

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    Background: Urinary incontinence (UI) affects half of patients hospitalised after stroke and is often poorly managed. Cochrane systematic reviews have shown some positive impact of conservative interventions (such as bladder training) in reducing UI, but their effectiveness has not been demonstrated with stroke patients. Methods: We conducted a cluster randomised controlled feasibility trial of a systematic voiding programme (SVP) for the management of UI after stroke. Stroke services were randomised to receive SVP (n = 4), SVP plus supported implementation (SVP+, n = 4), or usual care (UC, n = 4). Results: It was possible to recruit patients (413; 164 SVP, 125 SVP+, and 124 UC) and participant retention was acceptable (85% and 88% at six and 12 weeks, respectively). There was no suggestion of a beneficial effect on the main outcome at six (SVP versus UC: odds ratio (OR) 0.94, 95% CI: 0.46 to 1.94; SVP+ versus UC: OR: 0.62, 95% CI: 0.28 to 1.37) or 12 weeks (SVP versus UC: OR: 1.02, 95% CI: 0.54 to 1.93; SVP+ versus UC: OR: 1.06, 95% CI: 0.54 to 2.09). Conclusions: The trial has met feasibility outcomes of participant recruitment and retention. It was not powered to demonstrate effectiveness, but there is some evidence of a potential reduction in the odds of specific types of incontinence. A full trial should now be considered.

    Original languageEnglish
    Article number509
    Pages (from-to)509
    Issue number1
    Early online date23 Dec 2014
    Publication statusPublished - 23 Dec 2014


    • Cluster randomised controlled trial
    • Feasibility
    • Stroke
    • Urinary incontinence
    • Humans
    • Wales
    • England
    • Male
    • Cognition
    • Urinary Incontinence/diagnosis
    • Cognitive Behavioral Therapy
    • Recovery of Function
    • Feasibility Studies
    • Patient Selection
    • Time Factors
    • Aged, 80 and over
    • Female
    • Odds Ratio
    • Stroke/complications
    • Treatment Outcome
    • Urinary Bladder/physiopathology
    • Urodynamics
    • Sample Size
    • Quality of Life
    • Aged


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