Table 2.
Details of the Self-Management Interventions Evaluated in Included Studies (N = 8)
| Component | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Study Author, Year | Education and Reassurancea | Fluid Management | Caffeine and Alcohol Reduction | Concurrent Medication | Toileting and Bladder Retraining | Miscellaneous (Advice) | Delivery Format/Clinician | Duration/Dose | Fidelity: Planned/Actual |
| Brown et al,23,36,42 2007 | Causes and natural history of symptoms; reassurance about prostate cancer | Timing (restriction before bedtime/social activities); amount (1.5-2 L) | Caffeine (replace with decaf); alcohol (avoid in evening; reduce intake) | Reschedule and/or substitute (diuretics) | Types of toileting (double voiding, urethral milking); bladder retraining (pelvic floor exercise, urge suppression, bladder diaries) | Avoiding constipation | Group sessions/trained specialist nurses | 3 sessions, 1.5-2 hours each | Specialist nurses trained in group facilitation and techniques to enhance self-management skills/93% of participants attended all sessions |
| Chen et al,26 2012 | Causes of symptoms; reassurance about prostate cancer | Timing (restriction before social activities/evening); amount (not excessive) | Caffeine (avoid); alcohol (avoid) | Reschedule (diuretics) | Types of toileting (double voiding, prompt voiding, urethral milking); bladder retraining (pelvic floor exercise) | Avoiding constipation; drinking cranberry juice | Individual face-toface and telephone follow-up/NR | 1 session, 2 hours | NR/NR |
| Burgio et al,29,43,44 2011 (MOTIVE trial) | NR | Timing (restriction after 6 pm) | NR | NR | Types of toileting (delayed voiding); bladder retraining (pelvic floor exercise, urge suppression, bladder diaries) | NR | NR/nurse practitioners | 4 sessions over 8 weeks | NR/88% of participants attended all sessions |
| Johnson et al,31,45 2016 (BEDTime trial) | NR | Timing (restriction before bedtime); amount (1.5-2 L) | Caffeine (avoid); alcohol (reduce before bedtime) | NR | Types of toileting (delayed voiding); bladder retraining (pelvic floor exercise, urge suppression, bladder diaries) | Sleep hygiene; peripheral edema management | Individual face-toface or telephone/nurse practitioners | 4 sessions over 10 weeks | Specialist nurses trained on how to administer behavioral treatments (3-hour initial session and twice-monthly research meetings)/median score = 4 on 5-point scaleb |
| Hut et al,27 2017 | Anatomy, function, and relationship with symptoms | Amount (≥2 L) | Caffeine (limit); alcohol (limit) | NR | Types of toileting (voiding techniques); bladder retraining (pelvic floor exercise, toilet behavior, bladder diaries) | Avoiding constipation | Individual sessions/NR | 6 sessions, 0.5-1 hour each, over 90 days | NR/NR |
| Burgio et al,30,46,47 2018 (COBALT trial) | NR | Timing (restriction before bedtime and at night) | NR | NR | Types of toileting (incremental delayed voiding); bladder retraining (pelvic floor exercise, bladder diaries) | NR | NR/NR | 3 sessions over 6 weeks | NR/NR |
| Paterson et al,32 1997c | NR NR NR |
NR NR Timing |
NR NR Advice on types of beverages |
NR NR NR |
Bladder retraining (pelvic floor exercise) Types of toileting (urethral milking) NR |
NR NR9Edema management; diet |
NR/study chief investigator | NR/NR | NR/99% completed required clinic visits |
| Spigt et al,28 2006 | NR | Amount (1.5 L of extra water daily) | NR | NR | NR | NR | NR/person not involved in effect measurements | Participants provided with 0.5-L glasses/24-hour water turnover increased by 359-ml in intervention group compared with placebo group | |
BEDTiMe = Behavior and Exercise Versus Drug Treatment in Men With Nocturia; BPH = benign prostatic hyperplasia; COBALT = Combined Behavioral and Drug Treatment of Overactive Bladder in Men; LUTS = lower urinary tract symptoms; MOTIVE = Male Overactive Bladder Treatment in Veterans; NR = not reported.
aAimed at increasing participants’ knowledge of the causes and natural history of BPH and LUTS.
bNurses asked, “Overall, how completely do you think you followed your treatment instructions?” On scale of 1 to 5 points, 4 corresponded to “most of the time.”
cStudy evaluated 3 single components of self-management for treating lower urinary tract symptoms: pelvic floor exercises (first row) vs urethral milking (second row) vs counseling (third row).