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Lower urinary tract symptoms and health-related quality of life in Hong Kong primary care: a cross-sectional study

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Abstract

Purpose

To estimate the prevalence of lower urinary tract symptoms (LUTS) in primary care using the International Continence Society symptom definition; to evaluate the association between LUTS and health-related quality of life (HRQOL); and to evaluate the treatment gaps.

Methods

Patients aged 40 and above were randomly recruited in a Hong Kong public primary care. Patients were asked (i) how often they experienced 18 individual LUTS during the past 4 weeks and (ii) whether they had sought treatments for their LUTS. The 12-Item Short Form Health Survey version 2 (SF-12 v2) and the modified Incontinence Impact Questionnaire-Short Form (IIQ-7) were used to measure HRQOL.

Results

500 patients completed the survey. 75.8% of the patients had at least one LUTS “at least sometimes”, with patients with a combination of storage, voiding, and post-micturition symptoms being the most prevalent (22.2%), followed by a combination of voiding and storage symptoms (14%). Only 14% of LUTS patients had sought treatments for their LUTS. LUTS was associated with a negative effect in all domains of the SF-12 v2 and IIQ-7 and patients with a combination of storage, voiding, and post-micturition symptoms had the worst HRQOL. Finally, having a combination of storage, voiding, and post-micturition symptoms and poorer HRQOL were factors associated with having sought treatments for LUTS.

Conclusion

A high prevalence of LUTS but low treatment-seeking rates implied possible unmet needs of LUTS patients in primary care, suggesting the potential for more active interventions to alleviate the negative impact of LUTS on patients’ HRQOL.

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References

  1. Wang, Y., et al. (2015). Prevalence, risk factors and the bother of lower urinary tract symptoms in China: A population-based survey. International Urogynecology Journal,26(6), 911–919.

    Article  PubMed  Google Scholar 

  2. Choi, E. P., Lam, C. L., & Chin, W.-Y. (2014). Validation of the International Prostate Symptom Score in Chinese males and females with lower urinary tract symptoms. Health and Quality of Life Outcomes,12(1), 1.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Lukacz, E. S., et al. (2017). Urinary incontinence in women: A review. JAMA,318(16), 1592–1604.

    Article  PubMed  Google Scholar 

  4. Abrams, P., et al. (2002). The standardisation of terminology of lower urinary tract function: Report from the Standardisation Sub-committee of the International Continence Society. American Journal of Obstetrics and Gynecology,187(1), 116–126.

    Article  PubMed  Google Scholar 

  5. Irwin, D. E., et al. (2006). Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: Results of the EPIC study. European Urology,50(6), 1306–1315.

    Article  PubMed  Google Scholar 

  6. Coyne, K. S., et al. (2009). The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: Results from the Epidemiology of LUTS (EpiLUTS) study. BJU International,104(3), 352–360.

    Article  PubMed  Google Scholar 

  7. Chapple, C., et al. (2017). Prevalence of lower urinary tract symptoms in China, Taiwan, and South Korea: Results from a cross-sectional, population-based study. Advances in Therapy,34(8), 1953–1965.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wang, J.-Y., et al. (2018). Epidemiology of lower urinary tract symptoms in a cross-sectional, population-based study: The status in China. Medicine,97(34), e11554.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Jindal, T., et al. (2014). Misinterpretation of the international prostate symptom score questionnaire by Indian patients. Indian Journal of Urology,30(3), 252.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Johnson, T. V., et al. (2008). Patient misunderstanding of the individual questions of the American Urological Association symptom score. The Journal of Urology,179(6), 2291–2295.

    Article  PubMed  Google Scholar 

  11. Yee, C.-H., et al. (2014). The prevalence of lower urinary tract symptoms in a Chinese population, and the correlation with uroflowmetry and disease perception. International Urology and Nephrology,46(4), 703–710.

    Article  PubMed  Google Scholar 

  12. Form, Q. S. (2005). The impact of urinary incontinence on quality of life among women in Hong Kong. Hong Kong Medical Journal,11(3), 158–163.

    Google Scholar 

  13. Coyne, K. S., et al. (2009). The burden of lower urinary tract symptoms: Evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS. BJU International,103, 4–11.

    Article  PubMed  Google Scholar 

  14. Choi, E. P., Lam, C. L., & Chin, W.-Y. (2014). The health-related quality of life of Chinese patients with lower urinary tract symptoms in primary care. Quality of Life Research,23(10), 2723–2733.

    Article  PubMed  Google Scholar 

  15. Frankel, S. A., & Bourgeois, J. A. (2018). Integrated care for complex patients: A narrative medicine approach. New York: Springer.

    Book  Google Scholar 

  16. Chin, W. Y., et al. (2019). Cultural adaptation and psychometric properties of the Chinese Burden of Treatment Questionnaire (C-TBQ) in primary care patients with multi-morbidity. Family Practice,36(5), 657–665.

    Article  PubMed  Google Scholar 

  17. Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Frontiers in Psychology,4, 863.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lam, C. L., Eileen, Y., & Gandek, B. (2005). Is the standard SF-12 health survey valid and equivalent for a Chinese population? Quality of Life Research,14(2), 539–547.

    Article  PubMed  Google Scholar 

  19. Choi, E. P., et al. (2016). Health-related quality of life of Chinese patients with prostate cancer in comparison to general population and other cancer populations. Supportive Care in Cancer,24(4), 1849–1856.

    Article  PubMed  Google Scholar 

  20. Wong, C. K., et al. (2017). Use of the International Prostate Symptom Score (IPSS) in Chinese male patients with benign prostatic hyperplasia. The Aging Male,20(4), 241–249.

    Article  PubMed  Google Scholar 

  21. Chan, S. S., et al. (2010). Chinese validation of urogenital distress inventory and incontinence impact questionnaire short form. International Urogynecology Journal,21(7), 807–812.

    Article  PubMed  Google Scholar 

  22. Choi, E. P., Lam, C. L., & Chin, W.-Y. (2014). The Incontinence Impact Questionnaire-7 (IIQ-7) can be applicable to chinese males and females with lower urinary tract symptoms. The Patient-Patient-Centered Outcomes Research,7(4), 403–411.

    Article  PubMed  Google Scholar 

  23. Mobley, D., Feibus, A., & Baum, N. (2015). Benign prostatic hyperplasia and urinary symptoms: Evaluation and treatment. Postgraduate Medicine,127(3), 301–307.

    Article  PubMed  Google Scholar 

  24. Parsons, J. K. (2010). Benign prostatic hyperplasia and male lower urinary tract symptoms: Epidemiology and risk factors. Current Bladder Dysfunction Reports,5(4), 212–218.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Suen, L. K. P., et al. (2017). Qualitative insights into the experiences of living with moderate-to-severe lower urinary tract symptoms among community-dwelling ageing males. PLoS ONE,12(10), e0187085.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Uren, A. D., et al. (2017). Qualitative exploration of the patient experience of underactive bladder. European Urology,72(3), 402–407.

    Article  PubMed  Google Scholar 

  27. Bjorner, J. B., et al. (2007). Interpreting score differences in the SF-36 Vitality scale: Using clinical conditions and functional outcomes to define the minimally important difference. Current Medical Research and Opinion,23(4), 731–739.

    Article  PubMed  Google Scholar 

  28. Swanson, J. G., et al. (2002). Urinary incontinence in Canada. National survey of family physicians’ knowledge, attitudes, and practices. Canadian Family Physician,48(1), 86–92.

    PubMed  PubMed Central  Google Scholar 

  29. Nguyen, K., Hunter, K. F., & Wagg, A. (2013). Knowledge and understanding of urinary incontinence: Survey of family practitioners in northern Alberta. Canadian Family Physician,59(7), e330–e337.

    PubMed  PubMed Central  Google Scholar 

  30. Koch, L. H. (2006). Help-seeking behaviors of women with urinary incontinence: An integrative literature review. Journal of Midwifery & Women’s Health,51(6), e39–e44.

    Article  Google Scholar 

  31. Waetjen, L. E., et al. (2015). Factors associated with seeking treatment for urinary incontinence during the menopausal transition. Obstetrics and Gynecology,125(5), 1071.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Choi, E. P., et al. (2015). Evaluation of the effectiveness of nurse-led continence care treatments for Chinese primary care patients with lower urinary tract symptoms. PLoS ONE,10(6), e0129875.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Wang, C., et al. (2015). Effects of stigma on C hinese women’s attitudes towards seeking treatment for urinary incontinence. Journal of Clinical Nursing,24(7–8), 1112–1121.

    Article  PubMed  Google Scholar 

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Acknowledgement

The authors would like to thank Dr. Symphorosa S. C. Chan for the permission of using the Chinese IIQ-7.

Funding

The study was supported by Seed Fund for Basic Research (no: 201804159013), The University of Hong Kong.

Author information

Authors and Affiliations

  1. School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, Hong Kong

    Edmond Pui Hang Choi

  2. Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong, Hong Kong

    Eric Yuk Fai Wan, Weng Yee Chin & Cindy Lo Kuen Lam

  3. Department of Pharmacology and Pharmacy, University of Hong Kong, Hong Kong, Hong Kong

    Eric Yuk Fai Wan

Authors
  1. Edmond Pui Hang Choi
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  2. Eric Yuk Fai Wan
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  3. Weng Yee Chin
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  4. Cindy Lo Kuen Lam
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Corresponding author

Correspondence to Edmond Pui Hang Choi.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the institutional review board: HKWC (UW19-179). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all individual participants included in the study by the trained field worker.

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Choi, E.P.H., Wan, E.Y.F., Chin, W.Y. et al. Lower urinary tract symptoms and health-related quality of life in Hong Kong primary care: a cross-sectional study. Qual Life Res 29, 1311–1321 (2020). https://doi.org/10.1007/s11136-019-02402-7

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  • DOI: https://doi.org/10.1007/s11136-019-02402-7

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