Managing Urinary Incontinence in Older Adults- Pharmacy Technician
Urinary incontinence (UI) is a common condition in older adults. An estimated 30% to 50% of elderly women and 20 to 30% of elderly men are affected. Up to 10% of all nursing home admissions are attributed to UI, and over 50% of nursing home residents have UI. Incontinence can have a profound effect on well-being and quality of life; sufferers often experience social isolation, anxiety, depression, impaired sexual relationships, insomnia (if nocturia occurs), and an increased risk of falls and fractures. Other health consequences include urinary tract infections and urosepsis from urinary retention and indwelling catheters, and skin infections and pressure ulcers from constant moisture and irritation. Among community dwelling individuals in the U.S., the total cost of care including evaluation, treatment, home care, and nursing home admission was an estimated $14 billion in 2000. Despite its impact, UI is underreported by patients, underdetected by clinicians, and undertreated. Embarrassment, a belief among both patients and clinicians that UI is a normal part of aging, and an assumption that not much can be done for UI in older adults are key factors. Community healthcare providers can reduce the impact of UI by informing patients and other clinicians that effective management is attainable. This issue will present an overview of UI and the recommended, stepwise approach for managing the most common types in older adults. This issue will review the medications used for the treatment of urge UI and overactive bladder (OAB), including 6 antimuscarinicantimuscarinic agents and newer medications such as mirabegron (MyrbetriqTM) and onabotulinumtoxinA (BOTOX®). Medications used in the management of stress UI will also be discussed.