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).