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Urge Incontinence

Quality of Life and Patients’ Valuation of Symptom Reduction

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Abstract

Objective: Previous studies have demonstrated the effect of incontinence, and urge incontinence in particular, on patients’ quality of life. This study assessed the effects of urge incontinence on quality of life and measured the value of a reduction in symptoms.

Design: A self-administered questionnaire was mailed to 591 patients with urge or mixed incontinence. 495 (83.8%) surveys were returned with complete quality of life and symptom data. Of the total sample, 411 patients received the willingness- to-pay (WTP) survey, from which 257 (62.53%) returns were judged complete and reliable. Information was collected about the number of micturitions and urinary leakages. Health-related quality of life (HR-QOL) was measured using the Short Form 36 (SF-36) Health Survey. Socioeconomic characteristics were also recorded. Value was assessed with a binary WTP question.

Main outcome measures and results: Quality of life among the sample population was significantly lower in 5 of 8 dimensions compared with the general US population, and was significantly related to the severity of the symptoms in 6 of 8 dimensions. The median (mean) willingness to pay was $US27.24 ($US87.74) per month for a 25% reduction in micturitions and leakages, and $US75.92 ($US244.54) per month for a 50% reduction in micturitions and leakages. As expected, the willingness to pay was significantly related to the size of the reduction in micturitions and leakages, and household income.

Conclusions: Patients with incontinence perceive substantial benefits from a reduction in the number of micturitions and leakages.

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References

  1. Wyman JF. The psychiatric and emotional impact of femalepelvic floor dysfunction. Curr Opin Obstet Gynaecol 1994;6(4): 336–9

    CAS  Google Scholar 

  2. National Institutes of Health Consensus Development Conference.Urinary incontinence in adults. J Am Geriatr Soc 1990;38: 265–72

    Google Scholar 

  3. Burgio KL, Matthews KA, Engel BT. Prevalence, incidenceand correlates of urinary incontinence in health middle-agedwomen. J Urol 1991; 146(5): 1255–9

    PubMed  CAS  Google Scholar 

  4. Ziving LB, Foldspang A, Lam GW, et al. Descriptive epidemiologyof urinary incontinence in 3,100 women aged 30-59.Scand J Urol Nephrol 1989; 125: 37–43

    Google Scholar 

  5. Lenderking WR, Nackley JF, Anderson RB, et al. A review ofthe quality of life aspects of urinary urge incontinence. Pharmacoeconomics1996; 9(1): 11–23

    Article  PubMed  CAS  Google Scholar 

  6. Diokno AC, Brock BM, Brown MB, et al. Prevalence of urinaryincontinence and other urological symptoms in the non-institutionalizedelderly. J Urol 1986; 136: 1022–5

    PubMed  CAS  Google Scholar 

  7. Hunskaar S, Vinsnes A. The quality of life in women with urinaryincontinence as measured by the Sickness Impact Profile.J Am Geriatr Soc 1991; 39: 378–82

    PubMed  CAS  Google Scholar 

  8. Johannesson M, O’Conor RM, Kobelt-Nguyen G, et al. Willingnessto pay for reduced incontinence problems. Br J Urol1997; 80: 557–62

    Article  PubMed  CAS  Google Scholar 

  9. Russel LB, Gold MR, Siegel JR, et al. The role of cost-effectivenessanalysis in health and medicine. JAMA 1996; 276:1172–7

    Article  Google Scholar 

  10. Tolley GS, Kenkel D, Fabian R. Valuing health for policy:an economic approach. Chicago (IL): University of ChicagoPress, 1994

  11. Kenkel D. On valuing morbidity, cost-effectiveness analysis,and being rude. J Health Econ 1997; 16(6): 749–57

    Article  PubMed  CAS  Google Scholar 

  12. Mitchell RC, Carson RT. Using surveys to value public goods:the contingent valuation method. Washington: Resources forthe Future, 1989

  13. O’Conor RM, Blomquist GC. Measurement of consumer-patientpreferences using a hybrid contingent valuation method.J Health Econ 1997; 16(6): 667–84

    Article  PubMed  Google Scholar 

  14. Phillips KA, Homan RK, Luft HS, et al. Willingness to pay forpoison control centers. J Health Econ 1997; 16(3): 343–58

    Article  PubMed  CAS  Google Scholar 

  15. Dickie M, Gerking S. Formation of risk beliefs, joint production,and willingness to pay to avoid skin cancer. Rev EconStat 1996; 78 (3): 451–63

    Article  Google Scholar 

  16. Kartman B, Andersson F, Johannesson M. Willingness to payfor reductions in angina pectoris attacks. Med Decis Making1996; 16: 248–53

    Article  PubMed  CAS  Google Scholar 

  17. Kartman B, Stlhammar N-O, Johannesson M. Valuation ofhealth changes with the contingent valuation method: a testof scope and question order effects. Health Econ 1996; 5:531–41

    Article  PubMed  CAS  Google Scholar 

  18. Chestnut LG, Keller LR, Lambert WE, et al. Measuring heartpatients’ willingness to pay for changes in angina symptoms.Med Decis Making 1996; 16(1): 65–77

    Article  PubMed  CAS  Google Scholar 

  19. Johannesson M, Johansson P-O, Kristrm B, et al. Willingnessto pay for antihypertensive therapy: further results. J HealthEcon 1993; 12: 95–108

    Article  PubMed  CAS  Google Scholar 

  20. Stewart AL, Hays RD, Ware JE.The MOS short-form general health survey reliability and validity in a patient population. Med Care 1988; 26 724–35

    Article  PubMed  CAS  Google Scholar 

  21. National Oceanic and Atmospheric Administration. Report ofthe NOAA panel on contingent valuation. Fed Regist 1993;58: 4602–14

    Google Scholar 

  22. Ware JE, Snow K, Kosinski M, et al. SF-36 Health SurveyManual and Interpretation Guide. Boston (MA): Health Instituteof the New England Medical Center, 1993

  23. Cameron TA. A new paradigm for valuing non-market goodsusing referendum data: maximum likelihood estimation bycensored logistic regression. J Environ Econ Manage 1988;15: 355–79

    Article  Google Scholar 

  24. Kristrm B. A non-parametric approach to the estimation ofwelfare measures in discrete response valuation studies. LandEcon 1990; 66: 135–9

    Article  Google Scholar 

  25. Bishop RC, Heberlein TA.Measuring values of extramarketgoods: are indirect measures biased? Am J Agric Econ 1979;61: 926–30

    Article  Google Scholar 

  26. Park T, Loomis JB, Creel M. Confidence intervals for evaluating benefits estimates from dichotomous choice contingentvaluation studies. Land Econ 1991; 67: 64–73

    Article  Google Scholar 

  27. Cummings RG, Harrison GW, Rutstrm EE. Homegrown valuesand hypothetical surveys: is the dichotomous choice approachincentive-compatible? Am Econ Rev 1995; 85(1):260–6

    Google Scholar 

Download references

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Correspondence to Richard M. O’Conor.

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O’Conor, R.M., Johannesson, M., Hass, S.L. et al. Urge Incontinence. Pharmacoeconomics 14, 531–539 (1998). https://doi.org/10.2165/00019053-199814050-00005

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