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

Lookup NU author(s): Dr Lois Thomas, Joanna Booth, Emerita Professor Elaine McCollORCiD, Emerita Professor Helen Rodgers, Dr Katie Brittain, Gill Pearl



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© Thomas et al.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.

Publication metadata

Author(s): Thomas LH, Watkins CL, Sutton CJ, Forshaw D, Leathley MJ, French B, Burton CR, Cheater F, Roe B, Britt D, Booth J, McColl E, Leathley M, Carter B, Booth J, Burton C, Rodgers H, Brittain K, Walker A, Barrett J, Whiteley G, Brand P, Griffiths M, Helvin P, James B, Pearl G, Whitewood J, Vella J, Childs R, Crosby S, Hall S, Lewin A, Royle L, Scott C, Wright J

Publication type: Article

Publication status: Published

Journal: Trials

Year: 2014

Volume: 15

Online publication date: 23/12/2014

Acceptance date: 09/12/2014

Date deposited: 13/11/2017

ISSN (electronic): 1745-6215

Publisher: BioMed Central Ltd


DOI: 10.1186/1745-6215-15-509


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Funder referenceFunder name
RP-PG-0707-10059National Institute for Health Research (NIHR)