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Supporting better adherence among patients engaged in intermittent self-catherisation

24 January 2019
Focus
02 January 2019
Volume 28 · Issue 2

Abstract

Coloplast has conducted a qualitative study among health professionals working in the field of continence care. Interviews with health professionals working in urology and rehabilitation provided insights into the barriers to, and supporters of, adherent behaviour—suggesting ways in which health professionals can work with patients performing intermittent self-catheterisation (ISC) to support better adherence. This includes individualised training that addresses individual fears, ensures correct understanding of the body and the treatment, and eliminates misconceptions. They can also help patients set realistic ambitions, and give them practical advice that will help them adapt ISC to their daily life. Patients need to know how to handle urinary tract infections, how to cope with contradictory instructions from other sources, and how to identify support resources and accurate information. Specific challenges relating to support for urology patients and rehabilitation patients were also highlighted.

For patients with chronic health issues adhering to the prescribed treatment is key to their ability to cope effectively with their illness and enjoy a better quality of life. However, research indicates that adherence is an issue for many chronically ill individuals. According to the World Health Organization (2003), adherence to treatment is a challenge for no less than 50% of patients with chronic conditions.

The same issue applies to people living with continence and voiding issues, many of whom are also chronically ill (e.g. those with neurological conditions such as spinal cord injury, multiple sclerosis or spina bifida). The gold standard of treatment for this group of patients is intermittent self-catheterisation (ISC). It is well-documented that ISC ensures better quality of life (Vahr et al, 2013) and good bladder health (Weld and Dmochowski, 2000) for this group of people. However, studies reveal that ISC adherence rates decline significantly over time. In the USA, for example, there is a 50% reduction in adherence rates in the first 5 years after rehabilitation discharge (Cameron et al, 2010).

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Continence care
Long-term conditions
Adherence
Behaviour change
Patient support
Health Action Process Approach (HAPA)