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Meta-Analysis
. 2008 Oct 8;2008(4):CD007408.
doi: 10.1002/14651858.CD007408.

Absorbent products for moderate-heavy urinary and/or faecal incontinence in women and men

Mandy Fader  1 , Alan M Cottenden, Kathryn Getliffe
Affiliations
Meta-Analysis

Absorbent products for moderate-heavy urinary and/or faecal incontinence in women and men

Mandy Fader et al. Cochrane Database Syst Rev. .

Abstract

Background: Incontinence is a common and embarrassing problem which has a profound effect on social and psychological well-being. Many people wear absorbent products to contain urine and/or faeces and protect their clothes and dignity. Users of absorbent pads are very diverse, including younger women, particularly those who have had children, older men with prostate disease, people with neurological conditions and older people with mobility and mental impairment. Whilst small absorbent pads for light incontinence are adequate for some users with low volumes of urine loss, for others with higher volumes more absorbent products are needed. A practical definition of moderate-heavy incontinence is urine or faecal loss that requires a large absorbent pad (typically with a total absorbent capacity of 2000 g to 3000 g) for containment.

Objectives: To assess the effectiveness of the different types of absorbent product designed for moderate-heavy incontinence.

Search strategy: We searched the Cochrane Incontinence Group Specialised Register for trials carried out between 1 January 1998 and 1 January 2008 (searched 7 February 2008), and the reference lists of relevant articles. Absorbent pads are subject to frequent modification by manufacturers and trials more than 10 years old were therefore not included in this review.

Selection criteria: All randomised or quasi-randomised trials of absorbent products for moderate-heavy incontinence.

Data collection and analysis: Two review authors assessed the methodological quality of potentially eligible studies and independently extracted data from the included trials.

Main results: Two studies with a total of 185 participants met the selection criteria. These trials studied all the absorbent product designs included in this review. One trial took place in nursing homes, the other in people's own homes. Gender was found to be a significant variable in both trials, and accordingly the results were analysed in gender groups. Data were presented on all included outcomes, except for quality of life.The results show that there is no single best design (i.e. one design that is significantly better than all other designs and for all users). Of the disposable designs, the more expensive pull-up and T-shaped diaper designs were not better overall than the diaper for men, but the diaper was better than the insert (the cheapest), making the diaper the most cost-effective disposable design for men both day and night. For women, disposable pull-ups were better overall than the other designs (except for those living in nursing homes when disposable diapers are better when used at night), but they are expensive. Unlike men, women in the community did not favour diapers (or T-shape diapers) and insert pads are therefore the most cost-effective alternative. Washable diapers are the least expensive design but are unacceptable to most women at any time. However, some people (particularly men living at home) prefer them at night and for them they are a cost-effective design.No firm conclusions could be drawn about the performance of designs for faecal incontinence and there was no firm evidence that there are differences in skin health between designs.

Authors' conclusions: Although data were available from only two eligible trials the data were sufficiently robust to make some recommendations for practice. There is evidence that different designs are better for men and women. Diapers are the most cost-effective disposable design for men. Disposable pull-ups are most preferred for women but are expensive: disposable inserts are a cheaper alternative (except in nursing homes where diapers are preferred to inserts at night). Washable diapers are the cheapest design but have limited acceptability, confined mainly to some men at night. There were not enough people in the trials to draw any conclusions about which designs are best for faecal incontinence and no particular design seemed to be better or worse for skin health. People have different preferences for absorbent product designs and using a combination (different designs for day/night, going out/staying in) may be more effective and less expensive than using one design all the time.

PubMed Disclaimer

Conflict of interest statement

The authors of this review are also the authors of the two included trials.

Figures

1.1
1.1. Analysis
Comparison 1 Disposable insert pad versus disposable diaper (day), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
1.2
1.2. Analysis
Comparison 1 Disposable insert pad versus disposable diaper (day), Outcome 2 Prevention of leakage (faeces): number rating design poor versus good/okay.
1.3
1.3. Analysis
Comparison 1 Disposable insert pad versus disposable diaper (day), Outcome 3 Discreetness (invisibility under clothes): number rating design poor versus good/okay.
1.4
1.4. Analysis
Comparison 1 Disposable insert pad versus disposable diaper (day), Outcome 4 Staying in place: number rating design poor versus good/okay.
1.5
1.5. Analysis
Comparison 1 Disposable insert pad versus disposable diaper (day), Outcome 5 Mean number of incontinence laundry items per 24 hours.
1.6
1.6. Analysis
Comparison 1 Disposable insert pad versus disposable diaper (day), Outcome 6 Skin health problems: number recording a little/a lot versus none.
1.7
1.7. Analysis
Comparison 1 Disposable insert pad versus disposable diaper (day), Outcome 7 Overall opinion: number rating design poor versus good/okay.
1.8
1.8. Analysis
Comparison 1 Disposable insert pad versus disposable diaper (day), Outcome 8 Preference: number not preferring design.
1.9
1.9. Analysis
Comparison 1 Disposable insert pad versus disposable diaper (day), Outcome 9 Ease of putting on: number rating design poor versus good/okay.
2.1
2.1. Analysis
Comparison 2 Disposable insert pad versus disposable T‐shaped diaper (day), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
2.2
2.2. Analysis
Comparison 2 Disposable insert pad versus disposable T‐shaped diaper (day), Outcome 2 Prevention of leakage (faeces): number rating design poor versus good/okay.
2.3
2.3. Analysis
Comparison 2 Disposable insert pad versus disposable T‐shaped diaper (day), Outcome 3 Discreetness (invisibility under clothes): number rating design poor versus good/okay.
2.4
2.4. Analysis
Comparison 2 Disposable insert pad versus disposable T‐shaped diaper (day), Outcome 4 Staying in place: number rating design poor versus good/okay.
2.5
2.5. Analysis
Comparison 2 Disposable insert pad versus disposable T‐shaped diaper (day), Outcome 5 Mean number of incontinence laundry items per 24 hours.
2.6
2.6. Analysis
Comparison 2 Disposable insert pad versus disposable T‐shaped diaper (day), Outcome 6 Skin health problems: number recording a little/a lot versus none.
2.7
2.7. Analysis
Comparison 2 Disposable insert pad versus disposable T‐shaped diaper (day), Outcome 7 Overall opinion: number rating design poor versus good/okay.
2.8
2.8. Analysis
Comparison 2 Disposable insert pad versus disposable T‐shaped diaper (day), Outcome 8 Ease of putting on: number rating design poor versus good/okay.
2.9
2.9. Analysis
Comparison 2 Disposable insert pad versus disposable T‐shaped diaper (day), Outcome 9 Preference: number preferring design.
3.1
3.1. Analysis
Comparison 3 Disposable pull‐up versus disposable diaper (day), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
3.2
3.2. Analysis
Comparison 3 Disposable pull‐up versus disposable diaper (day), Outcome 2 Prevention of leakage (faeces): number rating design poor versus good/okay.
3.3
3.3. Analysis
Comparison 3 Disposable pull‐up versus disposable diaper (day), Outcome 3 Ease of putting on: number rating design poor versus good/okay.
3.4
3.4. Analysis
Comparison 3 Disposable pull‐up versus disposable diaper (day), Outcome 4 Discreetness (invisibility under clothes): number rating design poor versus good/okay.
3.5
3.5. Analysis
Comparison 3 Disposable pull‐up versus disposable diaper (day), Outcome 5 Staying in place: number rating design poor versus good/okay.
3.6
3.6. Analysis
Comparison 3 Disposable pull‐up versus disposable diaper (day), Outcome 6 Mean number of incontinence laundry items per 24 hours.
3.7
3.7. Analysis
Comparison 3 Disposable pull‐up versus disposable diaper (day), Outcome 7 Skin health problems: number recording a little/a lot versus none.
3.8
3.8. Analysis
Comparison 3 Disposable pull‐up versus disposable diaper (day), Outcome 8 Overall opinion: number rating design poor versus good/okay.
3.9
3.9. Analysis
Comparison 3 Disposable pull‐up versus disposable diaper (day), Outcome 9 Preference: number preferring design.
4.1
4.1. Analysis
Comparison 4 Disposable pull‐up versus disposable insert pad (day), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
4.2
4.2. Analysis
Comparison 4 Disposable pull‐up versus disposable insert pad (day), Outcome 2 Prevention of leakage (faeces): number rating design poor versus good/okay.
4.3
4.3. Analysis
Comparison 4 Disposable pull‐up versus disposable insert pad (day), Outcome 3 Ease of putting on: number rating design poor versus good/okay.
4.4
4.4. Analysis
Comparison 4 Disposable pull‐up versus disposable insert pad (day), Outcome 4 Discreetness (invisibility under clothes): number rating design poor versus good/okay.
4.5
4.5. Analysis
Comparison 4 Disposable pull‐up versus disposable insert pad (day), Outcome 5 Staying in place: number rating design poor versus good/okay.
4.6
4.6. Analysis
Comparison 4 Disposable pull‐up versus disposable insert pad (day), Outcome 6 Mean number of incontinence laundry items per 24 hours.
4.7
4.7. Analysis
Comparison 4 Disposable pull‐up versus disposable insert pad (day), Outcome 7 Skin health problems: number recording a little/a lot versus none.
4.8
4.8. Analysis
Comparison 4 Disposable pull‐up versus disposable insert pad (day), Outcome 8 Overall opinion: number rating design poor versus good/okay.
4.9
4.9. Analysis
Comparison 4 Disposable pull‐up versus disposable insert pad (day), Outcome 9 Preference: number preferring design.
5.1
5.1. Analysis
Comparison 5 Disposable pull‐up versus T‐shaped diaper (day), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
5.2
5.2. Analysis
Comparison 5 Disposable pull‐up versus T‐shaped diaper (day), Outcome 2 Prevention of leakage (faeces): number rating design poor versus good/okay.
5.3
5.3. Analysis
Comparison 5 Disposable pull‐up versus T‐shaped diaper (day), Outcome 3 Ease of putting on: number rating design poor versus good/okay.
5.4
5.4. Analysis
Comparison 5 Disposable pull‐up versus T‐shaped diaper (day), Outcome 4 Discreetness (invisibility under clothes): number rating design poor versus good/okay.
5.5
5.5. Analysis
Comparison 5 Disposable pull‐up versus T‐shaped diaper (day), Outcome 5 Staying in place: number rating design poor versus good/okay.
5.6
5.6. Analysis
Comparison 5 Disposable pull‐up versus T‐shaped diaper (day), Outcome 6 Mean number of incontinence laundry items per 24 hours.
5.7
5.7. Analysis
Comparison 5 Disposable pull‐up versus T‐shaped diaper (day), Outcome 7 Skin health problems: number recording a little/a lot versus none.
5.8
5.8. Analysis
Comparison 5 Disposable pull‐up versus T‐shaped diaper (day), Outcome 8 Overall opinion: number rating design poor versus good/okay.
5.9
5.9. Analysis
Comparison 5 Disposable pull‐up versus T‐shaped diaper (day), Outcome 9 Preference: number preferring design.
6.1
6.1. Analysis
Comparison 6 Disposable diaper versus disposable T‐shaped diaper (day), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
6.2
6.2. Analysis
Comparison 6 Disposable diaper versus disposable T‐shaped diaper (day), Outcome 2 Prevention of leakage (faeces): number rating design poor versus good/okay.
6.3
6.3. Analysis
Comparison 6 Disposable diaper versus disposable T‐shaped diaper (day), Outcome 3 Ease of putting on: number rating design poor versus good/okay.
6.4
6.4. Analysis
Comparison 6 Disposable diaper versus disposable T‐shaped diaper (day), Outcome 4 Discreetness (invisibility under clothes): number rating design poor versus good/okay.
6.5
6.5. Analysis
Comparison 6 Disposable diaper versus disposable T‐shaped diaper (day), Outcome 5 Staying in place: number rating design poor versus good/okay.
6.6
6.6. Analysis
Comparison 6 Disposable diaper versus disposable T‐shaped diaper (day), Outcome 6 Mean number of incontinence laundry items per 24 hours.
6.7
6.7. Analysis
Comparison 6 Disposable diaper versus disposable T‐shaped diaper (day), Outcome 7 Skin health problems: number recording a little/a lot versus none.
6.8
6.8. Analysis
Comparison 6 Disposable diaper versus disposable T‐shaped diaper (day), Outcome 8 Overall opinion: number rating design poor versus good/okay.
6.9
6.9. Analysis
Comparison 6 Disposable diaper versus disposable T‐shaped diaper (day), Outcome 9 Preference: number preferring design.
7.1
7.1. Analysis
Comparison 7 Disposable diaper versus washable diaper (day), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
7.2
7.2. Analysis
Comparison 7 Disposable diaper versus washable diaper (day), Outcome 2 Discreetness (invisibility under clothes): number rating design poor versus good/okay.
7.3
7.3. Analysis
Comparison 7 Disposable diaper versus washable diaper (day), Outcome 3 Staying in place: number rating design poor versus good/okay.
7.4
7.4. Analysis
Comparison 7 Disposable diaper versus washable diaper (day), Outcome 4 Mean number of incontinence laundry items per 24 hours.
7.5
7.5. Analysis
Comparison 7 Disposable diaper versus washable diaper (day), Outcome 5 Skin health problems: number recording a little/a lot versus none.
7.6
7.6. Analysis
Comparison 7 Disposable diaper versus washable diaper (day), Outcome 6 Overall opinion: number rating design poor versus good/okay.
7.7
7.7. Analysis
Comparison 7 Disposable diaper versus washable diaper (day), Outcome 7 Preference: number preferring design.
7.8
7.8. Analysis
Comparison 7 Disposable diaper versus washable diaper (day), Outcome 8 Ease of putting on: number rating design poor versus good/okay.
8.1
8.1. Analysis
Comparison 8 Disposable insert pad versus disposable diaper (night), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
8.2
8.2. Analysis
Comparison 8 Disposable insert pad versus disposable diaper (night), Outcome 2 Prevention of leakage (faeces): number rating design poor versus good/okay.
8.3
8.3. Analysis
Comparison 8 Disposable insert pad versus disposable diaper (night), Outcome 3 Staying in place: number rating design poor versus good/okay.
8.4
8.4. Analysis
Comparison 8 Disposable insert pad versus disposable diaper (night), Outcome 4 Mean number of incontinence laundry items per 24 hours.
8.5
8.5. Analysis
Comparison 8 Disposable insert pad versus disposable diaper (night), Outcome 5 Skin health problems: number recording a little/a lot versus none.
8.6
8.6. Analysis
Comparison 8 Disposable insert pad versus disposable diaper (night), Outcome 6 Overall opinion: number rating design poor versus good/okay.
8.7
8.7. Analysis
Comparison 8 Disposable insert pad versus disposable diaper (night), Outcome 7 Preference: number preferring design.
8.8
8.8. Analysis
Comparison 8 Disposable insert pad versus disposable diaper (night), Outcome 8 Ease of putting on: number rating design poor versus good/okay.
9.1
9.1. Analysis
Comparison 9 Disposable insert pad versus disposable T‐shaped diaper (night), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
9.2
9.2. Analysis
Comparison 9 Disposable insert pad versus disposable T‐shaped diaper (night), Outcome 2 Prevention of leakage (faeces): number rating design poor versus good/okay.
9.3
9.3. Analysis
Comparison 9 Disposable insert pad versus disposable T‐shaped diaper (night), Outcome 3 Staying in place: number rating design poor versus good/okay.
9.4
9.4. Analysis
Comparison 9 Disposable insert pad versus disposable T‐shaped diaper (night), Outcome 4 Mean number of incontinence laundry items per 24 hours.
9.5
9.5. Analysis
Comparison 9 Disposable insert pad versus disposable T‐shaped diaper (night), Outcome 5 Skin health problems: number recording a little/a lot versus none.
9.6
9.6. Analysis
Comparison 9 Disposable insert pad versus disposable T‐shaped diaper (night), Outcome 6 Overall opinion: number rating design poor versus good/okay.
9.7
9.7. Analysis
Comparison 9 Disposable insert pad versus disposable T‐shaped diaper (night), Outcome 7 Preference: number preferring design.
9.8
9.8. Analysis
Comparison 9 Disposable insert pad versus disposable T‐shaped diaper (night), Outcome 8 Ease of putting on: number rating design poor versus good/okay.
10.1
10.1. Analysis
Comparison 10 Disposable pull‐up versus disposable insert pad (night), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
10.2
10.2. Analysis
Comparison 10 Disposable pull‐up versus disposable insert pad (night), Outcome 2 Prevention of leakage (faeces): number rating design poor versus good/okay.
10.3
10.3. Analysis
Comparison 10 Disposable pull‐up versus disposable insert pad (night), Outcome 3 Staying in place: number rating design poor versus good/okay.
10.4
10.4. Analysis
Comparison 10 Disposable pull‐up versus disposable insert pad (night), Outcome 4 Mean number of incontinence laundry items per 24 hours.
10.5
10.5. Analysis
Comparison 10 Disposable pull‐up versus disposable insert pad (night), Outcome 5 Skin health problems: number recording a little/a lot versus none.
10.6
10.6. Analysis
Comparison 10 Disposable pull‐up versus disposable insert pad (night), Outcome 6 Overall opinion: number rating design poor versus good/okay.
10.7
10.7. Analysis
Comparison 10 Disposable pull‐up versus disposable insert pad (night), Outcome 7 Preference: number preferring design.
10.8
10.8. Analysis
Comparison 10 Disposable pull‐up versus disposable insert pad (night), Outcome 8 Ease of putting on: number rating design poor versus good/okay.
11.1
11.1. Analysis
Comparison 11 Disposable pull‐up versus disposable diaper (night), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
11.2
11.2. Analysis
Comparison 11 Disposable pull‐up versus disposable diaper (night), Outcome 2 Prevention of leakage (faeces): number rating design poor versus good/okay.
11.3
11.3. Analysis
Comparison 11 Disposable pull‐up versus disposable diaper (night), Outcome 3 Staying in place: number rating design poor versus good/okay.
11.4
11.4. Analysis
Comparison 11 Disposable pull‐up versus disposable diaper (night), Outcome 4 Mean number of incontinence laundry items per 24 hours.
11.5
11.5. Analysis
Comparison 11 Disposable pull‐up versus disposable diaper (night), Outcome 5 Skin health problems: number recording a little/a lot versus none.
11.6
11.6. Analysis
Comparison 11 Disposable pull‐up versus disposable diaper (night), Outcome 6 Overall opinion: number rating design poor versus good/okay.
11.7
11.7. Analysis
Comparison 11 Disposable pull‐up versus disposable diaper (night), Outcome 7 Preference: number preferring design.
11.8
11.8. Analysis
Comparison 11 Disposable pull‐up versus disposable diaper (night), Outcome 8 Ease of putting on: number rating design poor versus good/okay.
12.1
12.1. Analysis
Comparison 12 Disposable pull‐up versus T‐shaped diaper (night), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
12.2
12.2. Analysis
Comparison 12 Disposable pull‐up versus T‐shaped diaper (night), Outcome 2 Prevention of leakage (faeces): number rating design poor versus good/okay.
12.3
12.3. Analysis
Comparison 12 Disposable pull‐up versus T‐shaped diaper (night), Outcome 3 Staying in place: number rating design poor versus good/okay.
12.4
12.4. Analysis
Comparison 12 Disposable pull‐up versus T‐shaped diaper (night), Outcome 4 Mean number of incontinence laundry items per 24 hours.
12.5
12.5. Analysis
Comparison 12 Disposable pull‐up versus T‐shaped diaper (night), Outcome 5 Skin health problems: number recording a little/a lot versus none.
12.6
12.6. Analysis
Comparison 12 Disposable pull‐up versus T‐shaped diaper (night), Outcome 6 Overall opinion: number rating design poor versus good/okay.
12.7
12.7. Analysis
Comparison 12 Disposable pull‐up versus T‐shaped diaper (night), Outcome 7 Preference: number preferring design.
12.8
12.8. Analysis
Comparison 12 Disposable pull‐up versus T‐shaped diaper (night), Outcome 8 Ease of putting on: number rating design poor versus good/okay.
13.1
13.1. Analysis
Comparison 13 Disposable diaper versus disposable T‐shaped diaper (night), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
13.2
13.2. Analysis
Comparison 13 Disposable diaper versus disposable T‐shaped diaper (night), Outcome 2 Prevention of leakage (faeces): number rating design poor versus good/okay.
13.3
13.3. Analysis
Comparison 13 Disposable diaper versus disposable T‐shaped diaper (night), Outcome 3 Staying in place: number rating design poor versus good/okay.
13.4
13.4. Analysis
Comparison 13 Disposable diaper versus disposable T‐shaped diaper (night), Outcome 4 Mean number of incontinence laundry items per 24 hours.
13.5
13.5. Analysis
Comparison 13 Disposable diaper versus disposable T‐shaped diaper (night), Outcome 5 Skin health problems: number recording a little/a lot versus none.
13.6
13.6. Analysis
Comparison 13 Disposable diaper versus disposable T‐shaped diaper (night), Outcome 6 Overall opinion: number rating design poor versus good/okay.
13.7
13.7. Analysis
Comparison 13 Disposable diaper versus disposable T‐shaped diaper (night), Outcome 7 Preference: number preferring design.
13.8
13.8. Analysis
Comparison 13 Disposable diaper versus disposable T‐shaped diaper (night), Outcome 8 Ease of putting on: number rating design poor versus good/okay.
14.1
14.1. Analysis
Comparison 14 Disposable diaper versus washable diaper (night), Outcome 1 Prevention of leakage (urine): number rating design poor versus good/okay.
14.2
14.2. Analysis
Comparison 14 Disposable diaper versus washable diaper (night), Outcome 2 Staying in place: number rating design poor versus good/okay.
14.3
14.3. Analysis
Comparison 14 Disposable diaper versus washable diaper (night), Outcome 3 Mean number of incontinence laundry items per 24 hours.
14.4
14.4. Analysis
Comparison 14 Disposable diaper versus washable diaper (night), Outcome 4 Skin health problems: number recording a little/a lot versus none.
14.5
14.5. Analysis
Comparison 14 Disposable diaper versus washable diaper (night), Outcome 5 Overall opinion: number rating design poor versus good/okay.
14.6
14.6. Analysis
Comparison 14 Disposable diaper versus washable diaper (night), Outcome 6 Preference: number preferring design.
14.7
14.7. Analysis
Comparison 14 Disposable diaper versus washable diaper (night), Outcome 7 Ease of putting on: number rating design poor versus good/okay.
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References

References to studies included in this review

Fader 2008 Comm men {unpublished data only}
    1. Fader M, Cottenden A, Getliffe K, Gage H, Clarke‐O'Neill S, Jamieson K, et al. Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs. Health Technology Assessment (Winchester, England) 2008 in press. - PubMed
Fader 2008 Comm women {unpublished data only}
    1. Fader M, Cottenden A, Getliffe K, Gage H, Clarke‐O'Neill S, Jamieson K, et al. Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs. Health Technology Assessment (Winchester, England) 2008 in press. - PubMed
Fader 2008 Community {unpublished data only}
    1. Fader M, Cottenden A, Getliffe K, Gage H, Clarke‐O'Neill S, Jamieson K, et al. Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs. Health Technology Assessment (Winchester, England) 2008 in press. - PubMed
Fader 2008 NH men {unpublished data only}
    1. Fader M, Cottenden A, Getliffe K, Gage H, Clarke‐O'Neill S, Jamieson K, et al. Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs. Health Technology Assessment (Winchester, England) 2008 in press. - PubMed
Fader 2008 NH women {unpublished data only}
    1. Fader M, Cottenden A, Getliffe K, Gage H, Clarke‐O'Neill S, Jamieson K, et al. Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs. Health Technology Assessment (Winchester, England) 2008 in press. - PubMed
Fader 2008 Nursing Homes {unpublished data only}
    1. Fader M, Cottenden A, Getliffe K, Gage H, Clarke‐O'Neill S, Jamieson K, et al. Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs. Health Technology Assessment (Winchester, England) 2008 in press. - PubMed

References to studies excluded from this review

Brown 1994 {published data only}
    1. Brown DS. Diapers and underpads, Part 1: Skin integrity outcomes. Ostomy Wound Management 1994;40(9):20‐8. - PubMed
    1. Brown DS. Diapers and underpads, Part 2: Cost outcomes. Ostomy Wound Management 1994;40(9):34‐44. - PubMed
Clancy 1991 {published data only}
    1. Clancy B, Malone‐Lee J. Reducing the leakage of body‐worn incontinence pads. Journal of Advanced Nursing 1991;16(2):187‐93. - PubMed
Cottenden 1993 {published data only}
    1. Cottenden AM, Ledger DJ. Predicting the performance of bodyworn disposable incontinence pads using laboratory tests. Journal of Biomedical Engineering 1993;15(3):212‐20. - PubMed
CPE 1998 {published data only}
    1. Cottenden AM, Fader M, Pettersson L, Clinton L, Dean G, Malone‐Lee J, Brooks R, Feneley R, Chadwick J. Disposable shaped bodyworn pads with pants for heavy incontinence. Disability Equipment Assesment report IN1 1998.
CPE 1999 {published data only}
    1. Cottenden AM, Fader M, Pettersson L, Clinton L, Dean G, Malone‐Lee J, Feneley R, Brooks R. All‐in‐one disposable bodyworn pads for heavy incontinence. Disability Equipment Assessment report IN4 1999.
Fader 1987 {published data only}
    1. Fader M, Barnes E, Malone‐Lee J, Cottenden A. Continence. Choosing the right garment... continence advisers. Nursing Times 1987;83(15):78‐85. - PubMed
Gallo 1997 {published data only}
    1. Gallo M, Staskin DR. Patient satisfaction with a reusable undergarment for urinary incontinence. Journal of Wound, Ostomy, & Continence Nursing 1997;24(4):226‐36. - PubMed
Gibb 1994 {published data only}
    1. Gibb H, Wong G. How to choose: nurses' judgements of the effectiveness of a range of currently marketed continence aids. Journal of Clinical Nursing 1994;3:77‐86. - PubMed
Harper 1995 {published data only}
    1. Harper DW, O'Hara PA, Lareau J, Cuss J, Black EK, Stewart A, et al. Reusable versus disposable incontinent briefs: A multiperspective crossover clinical trial. Journal of Applied Gerontology 1995;14(4):391‐407.
Hu 1988 {published data only}
    1. Hu TW, Kaltreider DL, Igou JF. Disposable versus reusable incontinent products: a controlled cost‐effectiveness experiment. Ostomy Wound Management 1988;21:46‐53. - PubMed
Macaulay 2004 {published data only}
    1. Macaulay M, Clarke‐O'Neill S, Fader M, Pettersson L, Cottenden A. A pilot study to evaluate reusable absorbent body‐worn products for adults with moderate/heavy urinary incontinence. Journal of Wound, Ostomy, & Continence Nursing 2004;31(6):357‐66. - PubMed

Additional references

Brazzelli 1999
    1. Brazzelli M, Shirran E, Vale L. Absorbent products for the containment of urinary and/or faecal incontinence in adults. Cochrane Database of Systematic Reviews 1999, Issue 3. [DOI: 10.1002/14651858.CD001406] - DOI - PubMed
Continence Found
    1. The Continence Foundation. Continence Product Directory. www.continence‐foundation.org.uk/directory/index.php. London: The Continence Foundation, (accessed 21 February 2007).
Cottenden 2005
    1. Cottenden A, Bliss D, Fader M, Getliffe K, Herrera H, Paterson J, Szonyi G, Wilde M. Management with continence products. In: Abrams P, Cardozo L, Khoury S, Wein A editor(s). Incontinence: 3rd International Consultation on Incontinence. Vol. 1, Plymouth: Health Publication Ltd, 2005:149‐253.
Deeks 2006
    1. Deeks JJ, Higgins JPT, Altman DG, editors. Analysing and presenting results. Cochrane Handbook for Systematic Reviews of Interventions 4.2.6 [updated September 2006]; Section 8. www.cochrane.org/resources/handbook/hbook.htm (accessed 1 May 2007).
Environment Agency 2005
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