Clinical Burden and Nonpharmacologic Management of Nursing Facility Residents with Overactive Bladder and/or Urinary Incontinence

Consult Pharm. 2015 Sep;30(9):533-42. doi: 10.4140/TCP.n.2015.533.


Objective: To identify clinical characteristics of residents with a diagnosis of overactive bladder (OAB) and/or urinary incontinence (UI) to determine the prevalence of comorbidities, severe mobility impairment (SMI), moderate-to-severe cognitive impairment (MSCI), and a toileting program and the response to that program.

Design: Cross-sectional retrospective analysis.

Setting: Skilled nursing facilities.

Patients, participants: Residents with a diagnosis of OAB and/or UI and an age range, and gender frequency-matched 1:1 control cohort without OAB and/or UI.

Interventions: None.

Main outcome measure(s): De-identified Minimum Data Set data 3.0 records (October 1, 2010, to September 30, 2012).

Results: Of the 175,632 residents, 65% had a diagnosis of UI and 1% had a diagnosis of OAB. Those with UI and/or OAB were more likely to have MSCI (mean Brief Inventory of Mental Status score 10.2 ± 4.5 vs. 12.5 ± 3.6; P = 0.001) and SMI (49.4% vs. 26.4%; P < 0.001), multiple comorbid conditions, falls and falls with injury, hip fractures (5.5% vs. 4.9%; P < 0.001), urinary tract infections (21.4% vs. 16.5%; P = 0.001), and moisture-associated skin damage (5.2% vs. 2.6%; P = 0.001) than the control cohort. Toileting programs were attempted more often (17.0% vs. 5.1%; P < 0.001) in those with UI and/or OAB but were only minimally successful, with 4.2% having decreased wetness and 0.9% being completely dry.

Conclusion: Residents with UI and/or OAB exhibit a higher burden of MSCI, SMI, and comorbidities than do residents without these diagnoses. Nonpharmacologic therapies such as toileting programs should be a primary focus in the nursing facility.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition Disorders / epidemiology*
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Skilled Nursing Facilities*
  • Urinary Bladder, Overactive / epidemiology*
  • Urinary Bladder, Overactive / therapy
  • Urinary Incontinence / epidemiology*
  • Urinary Incontinence / therapy