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An evaluation of disposable pads for women with light incontinence

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There is a wide range of pads available for women with light incontinence. However, there is little information on how well these products perform. Health professionals and purchasers experience a similar problem, with a dearth of impartial information to help inform and guide product purchase. The aim of this study was to evaluate the current range of disposable pads that are available for light incontinence.

Abstract

 

VOL: 99, ISSUE: 19, PAGE NO: 69

Sinead Clarke-O’Neill, MSc, RN, is project manager ; Lena Pettersson, MSc, RN, is project manager; Mandy Fader, PhD, BSc, RN is nurse director, all at the Continence Product Evaluation Network, University College London

Lena Pettersson, MSc, RN, is project manager; andMandy Fader, PhD, BSc, RN, is nurse director, both at the Continence Product Evaluation Network, University College London

 

 

There is a wide range of pads available for women with light incontinence. However, there is little information on how well these products perform. Health professionals and purchasers experience a similar problem, with a dearth of impartial information to help inform and guide product purchase. The aim of this study was to evaluate the current range of disposable pads that are available for light incontinence.

 


 

Subjects

 


 

Sixty women between the ages of 50 and 91 with a diagnosis of stress, urge or mixed incontinence took part in the evaluation; they were recruited by continence nurse specialists in the UK. Twelve products that were available on the UK market in September 2000 were included in the full evaluation. Also, ten pads with greater absorbency, produced by the same manufacturers, were included in a complementary evaluation. The less absorbent products have been termed Group A and the more absorbent products, Group B.

 


 

Study design

 


 

The study had a randomised multiple crossover design, with each subject testing all products. We were aware that because of the nature of their incontinence, different women will leak in different ways, for example by gushing or dribbling. A multiple crossover approach ensures that the products are treated equally since each subject evaluates all products.

 


 

Methods

 


 

Each subject was asked to test one of the less absorbent Group A products for five days, followed by the more absorbent Group B product for two days. (Two manufacturers did not have a Group B product, so during these weeks, the subjects tested Group A pads for seven days). The products were evaluated using three tools:

 


 

- Product performance questionnaire (Group A pads). This comprised 17 questions related to product performance. Subjects rated performance on a three-point scale (good, okay or poor);

 


 

- Product performance questionnaire (Group B pads). This was a short complementary questionnaire with five questions. Again, using a three-point scale, subjects were asked to rate how the product performed compared with its less absorbent counterpart (better, worse or same);

 


 

- A pad weight and leakage diary (Group A pads only). This enabled the collection of data regarding how much urine each product contained and if it leaked. Subjects were asked to rate leakage on a three-point scale (none, a little or a lot).

 


 

Results and discussion

 


 

Before the study began, a separate group of users were consulted on the pad features that they considered important. Leakage, fit and smell were rated as the three most important features by the 43 female respondents. Leakage has been chosen for discussion in this article. Also, overall opinion of the product is discussed as it sums up product performance.

 


 

Group A (Less absorbent products)

 


 

Statistically significant differences were found in 13 of the 17 areas on the product performance questionnaire (Table 1). Full results have been published in a report by the Medical Devices Agency (2002).

 


 

Leakage (Fig 1)

 


 

The pad weight and leakage diary results indicated that the mode of the urine weight (the most frequent weight of urine recorded in the pads) was 8g. Data show that with 10g of urine in the pad, between 81 per cent to 95 per cent of all disposable pads did not leak ‘at all’.

 


 

The best performing pad at 10g of urine (selected for closeness to the mean urine weight) was the ‘Tena Lady Extra’ pad, as 95 per cent did not leak at all with 10g of urine. However, the best performing pad at 20g and 40g of urine was the ‘Indasec Midi’.

 


 

All of the products generally performed well in terms of their ability to prevent leakage of urine.

 


 

The product performance questionnaire data represents the subjects’ opinion of leakage performance. The results indicated similar results to the pad weight and leakage diaries, and two products in particular performed well: ‘Anamini Extra’ and ‘Indasec Midi’. The least successful product was the ‘Attends 3’.

 


 

Overall opinion (Fig 2)

 


 

Subjects were asked to give a rating of ‘good’ if they thought the product was good and would continue to use it. In general, pads rated highly for overall opinion were also rated highly for other aspects of product performance.

 


 

Two products performed especially well for overall opinion: the ‘Prevail Extra Plus’ and ‘Tena Lady Extra’. Two products were considered ‘poor’ in terms of overall opinion: the ‘Attends 3’ and the ‘Molimed Classic Midi’.

 


 

Group B (More absorbent pads)

 


 

Less than 50 per cent of subjects rated the leakage performance of the more absorbent pads as ‘better’ than the less absorbent pads, and only about a third of the subjects found the more absorbent products to be better overall. In general, the more absorbent pads were considered less discreet than the less absorbent pads, which is not surprising as they look bigger and bulkier.

 


 

The results suggest that provision of more absorbent (and more expensive) products would not benefit most women. However, there remains a need for this type of product, as women with a larger body build tended to prefer larger products, probably to achieve a better fit.

 


 

Conclusion

 


 

All products performed well in terms of holding urine without leakage. This is encouraging as users see leakage as one of the most important aspects of pad performance. Even the least-favoured pad, the ‘Attends 3’, which was rated ‘poor’ for the largest number of performance aspects, had relatively good leakage results.

 


 

Two products scored very highly on most aspects of performance and were successful ‘all-rounders’: the ‘Tena Lady Extra’ and the ‘Prevail Extra Plus’.

 


 

The results suggest it is possible to buy pads that perform well on key performance aspects and are also reasonably priced (MDA, 2002). Purchasers, prescribers and users should look at the full evaluation results and focus on the products that scored well on performance aspects that are important to them, and consider cost.

 


 

The full version of this evaluation will be published in Ostomy and Continence Nursing later this year.

 


 

The CPE Network can be contacted at:

 


 

CPE Network, University College London, 3rd Floor, Clerkenwell Building, Archway Campus, Highgate Hill, London N19 5LW. Tel: 020 7288 5150

 


 

The full report and other CPE Network evaluations are available free for health and social care professionals from:

 


 

Medical Devices Agency Business Services, 9th Floor, Hannibal House, Elephant and Castle London SE1 6TQ

 


 

Tel: 020 7972 8360 Fax: 020 7972 8113

 


 

 


 

More information on disability equipment reports is at:

 


 

  • 1 Comment

Readers' comments (1)

  • Most services are looking to optimise their pad budgets and this group of low absorbency, high cost products are being replaced by washable items. An evaluation of the washables available for low need patients would be much more worth while for contractual decision-making within NHS continence services.

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