Hypothesis / aims of study
For the first time in Australia, nationally representative consumer data has been gathered over consecutive surveys in in 2017 and 2020 to provide insights into the experiences of Australians living with and affected by incontinence. The study aimed to increase understanding at the population level of incidence, perception, impact, knowledge, behaviour and action taken to address incontinence by respondents. Preliminary results from the 2021 survey are expected to be available by the ICS 2021 conference.
Study design, materials and methods
The researchers commissioned an external organisation to access and conduct online surveys of a representative sample of Australians in 2017 and 2020. The samples for the 2017 (n=1997) and 2020 (n=2054) surveys were broadly representative of the Australian population in terms of age, gender and geography. The surveys were conducted in line with the Research Society (formerly AMSRS) industry body guidelines. All data was de-identified prior to being received by the researchers. A third online survey is expected to be conducted in the first half of 2021. Response differences between the surveys were assessed at a level of statistical significance of 0.05.
Results
Incidence
Fourteen percent of Australians self-reported they currently experience incontinence according to the definition of ‘any involuntary leakage or loss of control of bladder or bowel’. However, in both 2017 and 2020, 31% of Australians stated they can lose a bit of control of their bladder/bowel on occasion.
Chronic conditions and at-risk groups
Compared to 2017, there was a significant increase in Australians with prostate issues (27% vs 46%, p= 0.00694) and ‘physical or intellectual disability’ (23% vs 31%, p= 0.0477) reporting incontinence in 2020. Australians living with diabetes, heart or cardiovascular disease and cancer were twice as likely as the general population to currently experience incontinence (p<0.00001 for each chronic condition listed).
Perceived risk of developing incontinence in the future
Sixty percent of Australians perceive their risk of developing incontinence in the future is moderate or higher (2020). Forty-eight percent of Australians believe incontinence is an inevitable consequence of ageing (2017 and 2020).
Help seeking and health advice
Only one in six Australians had ever discussed incontinence with their general practitioner (GP) or family doctor. Only one in six of those conversations occurred because the GP raised the issue of incontinence first.
Of Australians currently or previously experiencing incontinence, there was a significant increase in seeking help from both health professionals and the internet (p= 0.0002 & p= 0.01352 respectively) from 2017 to 2020. There was an associated decrease in the proportion relying solely on a health professional.
Health professional advice was significantly more likely to result in actions taken to manage incontinence facilitated by health professionals, including seeing a GP (p<0.00001), a specialist (p<0.00001) or calling a continence clinic or helpline (p=0.01828) compared to those who did not receive health professional input.
Pelvic floor exercises
In 2020, two-thirds of Australians were aware of pelvic floor exercises. Two in five stated they currently do pelvic floor exercises or have done them previously. Eighty percent who currently do pelvic floor exercises do them at least every couple of days.
Interpretation of results
Incidence
The proportion of Australians agreeing they lost a bit of control of bladder/bowel on occasion was more than double that agreeing they currently experience incontinence defined as ‘Any involuntary leakage or loss of control of bladder or bowel’. Thus, the incidence of incontinence in the Australian population might be higher than other prevalence estimates have indicated (Deloitte, 2011).
Chronic conditions and at-risk groups
Australians living with chronic conditions and in at-risk groups have a higher likelihood of currently experiencing incontinence. This highlights potential areas for education to address co-morbidities at a consumer and health professional level.
Perceived risk of developing incontinence in the future
The high proportion of Australians (60%) who believe their risk of developing incontinence in the future is moderate or higher may be linked to a misconceived belief that incontinence is an inevitable part of ageing. Interventions targeted to both younger and older age groups addressing key prevention messages and actions to take are required.
Help seeking and health professional advice
Advantage should be taken of the shift to digital health information to facilitate access to health professional interventions. Health professionals need to consider their digital health profile.
Pelvic floor exercises
Targeted advice and technologies to educate and prompt consumers on pelvic floor exercises as a front-line intervention may be an effective tool to help prevent and manage incontinence.