Use of the Dowell Bryant Incontinence Cost Index as a post-treatment outcome measure after non-surgical therapy

• Published in: Neurourology and urodynamics 2001, Vol.20 (1), p.85-93
• Main Authors: Simons, A.M., Dowell, C.J., Bryant, C.M., Prashar, S., Moore, K.H.
• Format: Article
• Language: English
• Subjects: Aged; Cost-Benefit Analysis; direct cost; Female; Health Care Costs; health outcome; Humans; Middle Aged; Treatment Outcome; urinary incontinence; Urinary Incontinence - physiopathology; Urinary Incontinence - therapy
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/1520-6777(2001)20:1<85::AID-NAU10>3.0.CO;2-T

The aim of this study was to use the previously validated Dowell Bryant Incontinence Cost Index (DBICI) as a post‐treatment outcome measure after non‐surgical therapy and to determine whether the magnitude of reduced leakage would correlate with the magnitude of reduced personal cost. A simple urethral occlusive device (Femassist) was employed in 57 women with stress, urge, or mixed incontinence for 1 month. The DBICI was administered at baseline and after device use, along with a visual analogue scale (VAS) for severity of incontinence impact, a 3‐day frequency volume chart (FVC) that documented leaks per 24 hours and pad usage, a 1‐hour ICS pad test at standard volume, and two disease‐pecific quality of life measures (Urogenital Distress Inventory [UDI] and Incontinence Impact Questionnaire [IIQ]). The severity of leakage was significantly reduced on all parameters, and the median personal costs of incontinence fell from AU$6.52 per week (IQR 1.50–10.59) to a median of AU$ 1.57 per week (IQR 0−4.89). A significant correlation (Kendall's rank, tau) was observed between reduction in personal costs and reduction in VAS (tau = 0.24, P= 0.01), leaks/day (tau = 0.20, P = 0.03), pad test loss (tau = 0.29, P = 0.002), and quality of life scores (UDI, tau = 0.23, P = 0.01; IIQ, tau = 0.26, P = 0.005). The personal costs subset of the DBICI appears to be a useful outcome measure for urinary incontinence research and could be widely employed to assess the impact of continence treatments on the patient's economic burden. Neurourol. Urodynam. 20:85–93, 2001. © 2001 Wiley‐Liss, Inc.