Urinary Incontinence Clinical Trial
Official title:
The Effect of Urox™(Crateva, Horsetail and Lindera Combination) in the Treatment of Overactive Bladder and Urinary Incontinence
This study aims to assess the efficacy of a specialized herbal formula, Urox, versus control over 8 weeks, in a double blind, placebo controlled trial. 150 participants are being recruited, randomized and administered treatment or placebo for the period of 8 weeks after initial eligibility screening. Outcome measures include previously validated tools such as the 3 day symptom diary measuring self-recorded day frequency, nocturia, urgency and incontinence episodes. Quality of life improvements are being measured using the Incontinence Impact Questionnaire, Urinary Distress Inventory and the short version of the OverActive Bladder survey.
Initial consultations were held at either the Brisbane campus of the Endeavour College of
Natural Medicine Naturopathic clinic or at Kelvin Grove Natural Medicine clinic, Brisbane.
Follow up interviews are being conducted via telephone. To minimize dropout rates,
participants are telephoned (as a reminder for the call and to complete the micturition
diaries) approximately 1 week before the scheduled interview time and were intermittently
called over the week following if they were unable to be reached at the scheduled interview
time. Three attending clinicians interviewed trial participants, all having participated in
interview training prior to any interviews being taken. The training was designed to ensure
utility of a uniform and consistent approach regarding how questions were asked and how data
was recorded.
The week prior to an initial consultation participants were requested to complete a
micturition diary and health related quality of life surveys, to serve as baseline measures.
The attending clinician then also completed a clinical data sheet, at the time of the
initial consultation, containing a range of questions including demographics, exercise,
health history and habits, which will be used to control and correlate data variables. Any
incomplete quality of life surveys at the outset were also completed at the first interview.
Micturition diaries are collected by post at 2, 4 and 8 week intervals along with the
completion of quality of life surveys and follow up clinical data sheet via telephone.
Participants were asked to keep the micturition diary for 3 days prior to each consultation
and were provided reply paid envelopes to return the surveys and unused capsules to assess
compliance.
For the primary outcome (day frequency) measure it was calculated that 90 participants
equally divided into placebo and control were required to detect a difference of 1.6 urinary
frequency episodes per day (2.7SD) between treatment and placebo groups, with a two-tailed
alpha of 0.05 and a power of 80%. For total incontinence, 53 participants were required
equally divided into each group to detect a difference of 1.2 episodes per day (2.2SD),
while for urgency 54 was required in each group to detect a difference of 2 per day (3.7SD).
To account for potential drop-outs and variations in presenting symptoms, a total of 150
participants were recruited.
Data for the two treatments will be compared using mixed effects ordered logistic regression
adjusted for repeated measures (Stata, version 13.1, StataCorp, TX, USA). GraphPad Prism
(version 6.00 for Windows, GraphPad Software, La Jolla California, USA) will be used to plot
the data. Data (day frequency, night frequency, urgency and incontinence) will be evaluated
by intention to treat analysis, with the last result brought forward for people who dropped
out or were lost to follow-up. Variables selected for adjustment using backward stepwise
regression from list including age, sex, water intake and diuretic use (p<0.22 for covariate
inclusion). Holm estimation test will be used to adjust p-values for repeated measures. Each
analysis will only included participants who are symptomatic at baseline. For example, in
relation to daytime urinary frequency - only participants with baseline of ≥10 will be
included in the analyses.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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