{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:20:57Z","timestamp":1788520857730,"version":"build-2803163510"},"reference-count":71,"publisher":"National Institute for Health and Care Research","issue":"41","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.nationalarchives.gov.uk\/doc\/non-commercial-government-licence\/non-commercial-government-licence.htm"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment programme","doi-asserted-by":"publisher","award":["15\/130\/73"],"award-info":[{"award-number":["15\/130\/73"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journalslibrary.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["Health Technol Assess"],"abstract":"\n Background<\/jats:title>\n Urinary incontinence is prevalent in nursing and residential care homes, and has a profound impact on residents\u2019 dignity and quality of life. Treatment options are limited in these care contexts and care homes predominantly use absorbent pads to contain incontinence, rather than actively treat it. Transcutaneous posterior tibial nerve stimulation is a non-invasive, safe, low-cost intervention that is effective in reducing urinary incontinence in adults.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the clinical effectiveness of transcutaneous posterior tibial nerve stimulation to treat urinary incontinence in care home residents and to determine the associated costs of the treatment.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A multicentre, pragmatic, participant and outcome assessor-blind, randomised placebo-controlled trial.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n A total of 37 UK residential and nursing care homes.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Care home residents with at least weekly urinary incontinence that is contained using absorbent pads and who are able to use a toilet\/toilet aid with or without assistance.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Residents were randomised (1\u2009:\u20091) to receive 12 30-minute sessions of transcutaneous posterior tibial nerve stimulation or sham stimulation over a 6-week period.<\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n Primary outcome \u2013 change in volume of urine leaked over a 24-hour period at 6 weeks. Secondary outcomes \u2013 number of pads used, Perception of Bladder Condition, toileting skills, quality of life and resource use.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 408 residents were randomised (transcutaneous posterior tibial nerve stimulation, n<\/jats:italic>\u2009=\u2009197; sham stimulation, n<\/jats:italic>\u2009=\u2009209); two exclusions occurred post randomisation. Primary outcome data were available for 345 (85%) residents (transcutaneous posterior tibial nerve stimulation, n<\/jats:italic>\u2009=\u2009167; sham stimulation, n<\/jats:italic>\u2009=\u2009178). Adherence to the intervention protocol was as follows: 78% of the transcutaneous posterior tibial nerve stimulation group and 71% of the sham group received the correct stimulation. Primary intention-to-treat adjusted analysis indicated a mean change of \u20135\u2009ml (standard deviation 362\u2009ml) urine leakage from baseline in the transcutaneous posterior tibial nerve stimulation group and \u201366\u2009ml (standard deviation 394\u2009ml) urine leakage in the sham group, which was a statistically significant, but not clinically important, between-group difference of 68-ml urine leakage (95% confidence interval 0 to 136\u2009ml; p<\/jats:italic>\u2009=\u20090.05) in favour of the sham group. Sensitivity analysis supported the primary analysis. No meaningful differences were detected in any of the secondary outcomes. No serious adverse events related to transcutaneous posterior tibial nerve stimulation were reported. Economic evaluation assessed the resources used. The training and support costs for the staff to deliver the intervention were estimated at \u00a3121.03 per staff member. Estimated costs for delivery of transcutaneous posterior tibial nerve stimulation during the trial were \u00a381.20 per participant. No significant difference was found between participants\u2019 scores over time, or between transcutaneous posterior tibial nerve stimulation and sham groups at any time point, for resident or proxy quality-of-life measures.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The ELECTRIC (ELECtric Tibial nerve stimulation to Reduce Incontinence in Care homes) trial showed, in the care home context (with a high proportion of residents with poor cognitive capacity and limited independent mobility), that transcutaneous posterior tibial nerve stimulation was not effective in reducing urinary incontinence. No economic case for transcutaneous posterior tibial nerve stimulation was made by the cost\u2013consequences analysis; however, the positive reception of learning about urinary incontinence for care home staff supports a case for routine education in this care context.<\/jats:p>\n <\/jats:sec>\n \n Limitations<\/jats:title>\n Completing 24-hour pad collections was challenging for care home staff, resulting in some missing primary outcome data.<\/jats:p>\n <\/jats:sec>\n \n Future work<\/jats:title>\n Research should investigate transcutaneous posterior tibial nerve stimulation in residents with urgency urinary incontinence to determine whether or not targeted stimulation is effective. Research should evaluate the effects of continence training for staff on continence care in care homes.<\/jats:p>\n <\/jats:sec>\n \n Trial registration<\/jats:title>\n Current Controlled Trials ISRCTN98415244 and ClinicalTrials.gov NCT03248362.<\/jats:p>\n <\/jats:sec>\n \n Funding<\/jats:title>\n This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment<\/jats:italic>; Vol. 25, No. 41. See the NIHR Journals Library website for further project information.<\/jats:p>\n <\/jats:sec>","DOI":"10.3310\/hta25410","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T08:38:04Z","timestamp":1624610284000},"page":"1-110","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Tibial nerve stimulation compared with sham to reduce incontinence in care home residents: ELECTRIC RCT"],"prefix":"10.3310","volume":"25","clinical-trial-number":[{"clinical-trial-number":"isrctn98415244","registry":"10.18810\/isrctn","type":"results"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7870-6391","authenticated-orcid":true,"given":"Joanne","family":"Booth","sequence":"first","affiliation":[{"name":"School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6277-7972","authenticated-orcid":true,"given":"Lorna","family":"Aucott","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7883-0608","authenticated-orcid":true,"given":"Seonaidh","family":"Cotton","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6935-0891","authenticated-orcid":true,"given":"Bridget","family":"Davis","sequence":"additional","affiliation":[{"name":"School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2536-8234","authenticated-orcid":true,"given":"Linda","family":"Fenocchi","sequence":"additional","affiliation":[{"name":"Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8938-4893","authenticated-orcid":true,"given":"Claire","family":"Goodman","sequence":"additional","affiliation":[{"name":"Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9741-9160","authenticated-orcid":true,"given":"Suzanne","family":"Hagen","sequence":"additional","affiliation":[{"name":"Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3596-6510","authenticated-orcid":true,"given":"Danielle","family":"Harari","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1685-4639","authenticated-orcid":true,"given":"Maggie","family":"Lawrence","sequence":"additional","affiliation":[{"name":"School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Lowndes","sequence":"additional","affiliation":[{"name":"Playlist for Life, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2906-8757","authenticated-orcid":true,"given":"Lisa","family":"Macaulay","sequence":"additional","affiliation":[{"name":"School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1039-5646","authenticated-orcid":true,"given":"Graeme","family":"MacLennan","sequence":"additional","affiliation":[{"name":"Health Services Research Unit, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9303-2794","authenticated-orcid":true,"given":"Helen","family":"Mason","sequence":"additional","affiliation":[{"name":"Health Services Research Unit, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2872-1702","authenticated-orcid":true,"given":"Doreen","family":"McClurg","sequence":"additional","affiliation":[{"name":"Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9823-9252","authenticated-orcid":true,"given":"John","family":"Norrie","sequence":"additional","affiliation":[{"name":"Usher Institute, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2259-0948","authenticated-orcid":true,"given":"Christine","family":"Norton","sequence":"additional","affiliation":[{"name":"Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9765-2464","authenticated-orcid":true,"given":"Catriona","family":"O\u2019Dolan","sequence":"additional","affiliation":[{"name":"School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6223-9840","authenticated-orcid":true,"given":"Dawn","family":"Skelton","sequence":"additional","affiliation":[{"name":"School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4312-6661","authenticated-orcid":true,"given":"Claire","family":"Surr","sequence":"additional","affiliation":[{"name":"School of Health and Community Studies, Leeds Beckett University, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7239-7241","authenticated-orcid":true,"given":"Shaun","family":"Treweek","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6221","published-online":{"date-parts":[[2021,6]]},"reference":[{"key":"key20210623091139587_ref1-bib1","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1186\/s13063-019-3723-7","article-title":"ELECtric Tibial nerve stimulation to Reduce Incontinence in Care homes: protocol for the ELECTRIC randomised trial","volume":"20","author":"Booth","year":"2019","journal-title":"Trials"},{"key":"key20210623091139587_ref1-bib2","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1002\/nau.23897","article-title":"The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction","volume":"38","author":"D\u2019Ancona","year":"2019","journal-title":"Neurourol Urodyn"},{"key":"key20210623091139587_ref1-bib3","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1080\/13697137.2018.1543263","article-title":"The prevalence of urinary incontinence","volume":"22","author":"Milsom","year":"2019","journal-title":"Climacteric"},{"key":"key20210623091139587_ref1-bib4","doi-asserted-by":"publisher","first-page":"e1001505","DOI":"10.1371\/journal.pmed.1001505","article-title":"First diagnosis and management of incontinence in older people with and without dementia in primary care: a cohort study using The Health Improvement Network primary care database","volume":"10","author":"Grant","year":"2013","journal-title":"PLOS Med"},{"key":"key20210623091139587_ref1-bib5","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1093\/ageing\/26.5.367","article-title":"Medically recognized urinary incontinence and risks of hospitalization, nursing home admission and mortality","volume":"26","author":"Thom","year":"1997","journal-title":"Age Ageing"},{"key":"key20210623091139587_ref1-bib6","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1111\/j.1524-4733.2006.00109.x","article-title":"Fraction of nursing home admissions attributable to urinary incontinence","volume":"9","author":"Morrison","year":"2006","journal-title":"Value Health"},{"key":"key20210623091139587_ref1-bib7","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1001\/jama.2019.12467","article-title":"Effect of behavioral and pelvic floor muscle therapy combined with surgery vs. surgery alone on incontinence symptoms among women with mixed urinary incontinence: the ESTEEM randomized clinical trial","volume":"322","author":"Sung","year":"2019","journal-title":"JAMA"},{"key":"key20210623091139587_ref1-bib8","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s12877-017-0414-7","article-title":"Urinary incontinence and its association with functional physical and cognitive health among female nursing home residents in Switzerland","volume":"17","author":"Schumpf","year":"2017","journal-title":"BMC Geriatr"},{"key":"key20210623091139587_ref1-bib9","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1111\/j.1532-5415.2006.00861.x","article-title":"The effect of urinary incontinence on quality of life in older nursing home residents","volume":"54","author":"Dubeau","year":"2006","journal-title":"J Am Geriatr Soc"},{"key":"key20210623091139587_ref1-bib10","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1093\/ageing\/afi039","article-title":"Prevalence of cognitive impairment: results from the MRC trial of assessment and management of older people in the community","volume":"34","author":"Rait","year":"2005","journal-title":"Age Ageing"},{"key":"key20210623091139587_ref1-bib11","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/S0004-9514(09)70038-8","article-title":"Urinary incontinence is associated with an increase in falls: a systematic review","volume":"55","author":"Chiarelli","year":"2009","journal-title":"Aust J Physiother"},{"key":"key20210623091139587_ref1-bib12","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.jtv.2016.02.004","article-title":"A decade of research on Incontinence-Associated Dermatitis (IAD): evidence, knowledge gaps and next steps","volume":"26","author":"Beeckman","year":"2017","journal-title":"J Tissue Viability"},{"key":"key20210623091139587_ref1-bib13","doi-asserted-by":"publisher","first-page":"146e1","DOI":"10.1016\/j.ajog.2012.11.010","article-title":"The association between urinary and fecal incontinence and social isolation in older women","volume":"208","author":"Yip","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"key20210623091139587_ref1-bib14","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.archger.2011.04.012","article-title":"Urinary incontinence (UI) and new psychological distress among community dwelling older adults","volume":"55","author":"de Vries","year":"2012","journal-title":"Arch Gerontol Geriatr"},{"key":"key20210623091139587_ref1-bib15","unstructured":"NHS England. Excellence in Continence Care: Practical Guidance for Commissioners, and Leaders in Health and Social Care. Leeds: NHS England; 2018."},{"key":"key20210623091139587_ref1-bib16","article-title":"Incontinence in Frail Older Persons","volume-title":"Incontinence 6th Edition","author":"Wagg","year":"2017"},{"key":"key20210623091139587_ref1-bib17","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1093\/ageing\/afq082","article-title":"Pad per day usage, urinary incontinence and urinary tract infections in nursing home residents","volume":"39","author":"Omli","year":"2010","journal-title":"Age Ageing"},{"key":"key20210623091139587_ref1-bib18","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1111\/j.1365-2648.2010.05481.x","article-title":"Systematic review of the management of incontinence and promotion of continence in older people in care homes: descriptive studies with urinary incontinence as primary focus","volume":"67","author":"Roe","year":"2011","journal-title":"J Adv Nurs"},{"key":"key20210623091139587_ref1-bib19","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1111\/j.1532-5415.2008.01681.x","article-title":"Dual use of bladder anticholinergics and cholinesterase inhibitors: long-term functional and cognitive outcomes","volume":"56","author":"Sink","year":"2008","journal-title":"J Am Geriatr Soc"},{"key":"key20210623091139587_ref1-bib20","doi-asserted-by":"publisher","first-page":"2298","DOI":"10.1111\/jgs.13713","article-title":"Challenges in the pharmacological management of nursing home residents with overactive bladder or urinary incontinence","volume":"63","author":"Zarowitz","year":"2015","journal-title":"J Am Geriatr Soc"},{"key":"key20210623091139587_ref1-bib21","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s40064-016-1687-6","article-title":"Inhibitory effects of tibial nerve stimulation on bladder neurophysiology in rats","volume":"5","author":"Choudhary","year":"2016","journal-title":"SpringerPlus"},{"key":"key20210623091139587_ref1-bib22","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1111\/j.1464-410X.2010.09358.x","article-title":"Suppression of bladder overactivity by activation of somatic afferent nerves in the foot","volume":"107","author":"Tai","year":"2011","journal-title":"BJU Int"},{"key":"key20210623091139587_ref1-bib23","doi-asserted-by":"publisher","first-page":"2210","DOI":"10.1097\/01.ju.0000067446.17576.bd","article-title":"Urodynamic effect of acute transcutaneous posterior tibial nerve stimulation in overactive bladder","volume":"169","author":"Amarenco","year":"2003","journal-title":"J Urol"},{"key":"key20210623091139587_ref1-bib24","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1002\/nau.23351","article-title":"The effectiveness of transcutaneous tibial nerve stimulation (TTNS) for adults with overactive bladder syndrome: a systematic review","volume":"37","author":"Booth","year":"2018","journal-title":"Neurourol Urodyn"},{"key":"key20210623091139587_ref1-bib25","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1007\/s00192-010-1165-6","article-title":"Randomized trial of transcutaneous tibial nerve stimulation to treat urge urinary incontinence in older women","volume":"21","author":"Schreiner","year":"2010","journal-title":"Int Urogynecol J"},{"key":"key20210623091139587_ref1-bib26","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.ejogrb.2015.09.020","article-title":"Transcutaneous posterior tibial nerve stimulation versus extended release oxybutynin in overactive bladder patients. A prospective randomized trial","volume":"196","author":"Manr\u00edquez","year":"2016","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"key20210623091139587_ref1-bib27","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1007\/s00345-013-1112-5","article-title":"Prospective and randomized comparison of electrical stimulation of the posterior tibial nerve versus oxybutynin versus their combination for treatment of women with overactive bladder syndrome","volume":"32","author":"Souto","year":"2014","journal-title":"World J Urol"},{"key":"key20210623091139587_ref1-bib28","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE guidelines: 1. Introduction \u2013 GRADE evidence profiles and summary of findings tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"key20210623091139587_ref1-bib29","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1016\/j.jamda.2012.10.021","article-title":"A feasibility study of transcutaneous posterior tibial nerve stimulation for bladder and bowel dysfunction in elderly adults in residential care","volume":"14","author":"Booth","year":"2013","journal-title":"J Am Med Dir Assoc"},{"key":"key20210623091139587_ref1-bib30","volume-title":"SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials)","author":"SPIRIT"},{"key":"key20210623091139587_ref1-bib31","unstructured":"Great Britain. Adults with Incapacity (Scotland) Act 2000. 2000. URL: www.legislation.gov.uk\/asp\/2000\/4\/contents (accessed 11 June 2020)."},{"key":"key20210623091139587_ref1-bib32","unstructured":"Great Britain. Mental Capacity Act 2005. 2005. URL: www.legislation.gov.uk\/ukpga\/2005\/9 (accessed 11 June 2020)."},{"key":"key20210623091139587_ref1-bib33","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1016\/j.eururo.2006.01.007","article-title":"The validation of the patient perception of bladder condition (PPBC): a single-item global measure for patients with overactive bladder","volume":"49","author":"Coyne","year":"2006","journal-title":"Eur Urol"},{"key":"key20210623091139587_ref1-bib34","doi-asserted-by":"publisher","DOI":"10.3928\/00989134-20160531-02","article-title":"Reliability and validity of two measures of toileting skills in frail older women without dementia [published online ahead of print 3 June 2016]","author":"Talley","year":"2016","journal-title":"J Gerontol Nurs"},{"issue":"10","key":"key20210623091139587_ref1-bib35","doi-asserted-by":"publisher","DOI":"10.3310\/hta9100","article-title":"Measurement of health-related quality of life for people with dementia: development of a new instrument (DEMQOL) and an evaluation of current methodology","volume":"9","author":"Smith","year":"2005","journal-title":"Health Technol Assess"},{"key":"key20210623091139587_ref1-bib36","volume-title":"Reference Costs 2017\/18: Highlights, Analysis and Introduction to the Data","author":"NHS Improvement","year":"2018"},{"key":"key20210623091139587_ref1-bib37","volume-title":"Unit Costs of Health and Social Care 2019","author":"Curtis","year":"2019"},{"key":"key20210623091139587_ref1-bib38","volume-title":"British National Formulary.","author":"Joint Formulary Committee"},{"key":"key20210623091139587_ref1-bib39","doi-asserted-by":"publisher","first-page":"45","DOI":"10.2147\/CIA.S25326","article-title":"Effect of physical training on urinary incontinence: a randomized parallel group trial in nursing homes","volume":"7","author":"Vinsnes","year":"2012","journal-title":"Clin Interv Aging"},{"key":"key20210623091139587_ref1-bib40","doi-asserted-by":"publisher","first-page":"3571","DOI":"10.1002\/sim.1585","article-title":"Simple procedures for blinded sample size adjustment that do not affect the type I error rate","volume":"15","author":"Kieser","year":"2003","journal-title":"Stat Med"},{"issue":"5","key":"key20210623091139587_ref1-bib41","doi-asserted-by":"publisher","DOI":"10.3310\/hta17050","article-title":"Development of DEMQOL-U and DEMQOL-PROXY-U: generation of preference-based indices from DEMQOL and DEMQOL-PROXY for use in economic evaluation","volume":"17","author":"Mulhern","year":"2013","journal-title":"Health Technol Assess"},{"key":"key20210623091139587_ref1-bib42","volume-title":"Methods for the Economic Evaluation of Health Care Programmes","author":"Drummond","year":"2015","edition":"4th"},{"key":"key20210623091139587_ref1-bib43","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1017\/S0033291706009469","article-title":"Development of a new measure of health-related quality of life for people with dementia: DEMQOL","volume":"37","author":"Smith","year":"2007","journal-title":"Psychol Med"},{"key":"key20210623091139587_ref1-bib44","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1177\/0272989X18784291","article-title":"Estimating a preference-based single index measuring the quality-of-life impact of self-management for diabetes","volume":"38","author":"Rowen","year":"2018","journal-title":"Med Decis Making"},{"key":"key20210623091139587_ref1-bib45","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1007\/s40258-016-0293-7","article-title":"An empirical comparison of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U in a post-hospitalisation population of frail older people living in residential aged care","volume":"15","author":"Ratcliffe","year":"2017","journal-title":"Appl Health Econ Health Policy"},{"key":"key20210623091139587_ref1-bib46","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1136\/qshc.2006.018499","article-title":"Qualitative methods in a randomised controlled trial: the role of an integrated qualitative process evaluation in providing evidence to discontinue the intervention in one arm of a trial of a decision support tool","volume":"16","author":"Murtagh","year":"2007","journal-title":"Qual Saf Health Care"},{"key":"key20210623091139587_ref1-bib47","doi-asserted-by":"publisher","first-page":"e002889","DOI":"10.1136\/bmjopen-2013-002889","article-title":"What can qualitative research do for randomised controlled trials? A systematic mapping review","volume":"3","author":"O\u2019Cathain","year":"2013","journal-title":"BMJ Open"},{"key":"key20210623091139587_ref1-bib48","doi-asserted-by":"publisher","first-page":"e0188225","DOI":"10.1371\/journal.pone.0188225","article-title":"Experiences of older people with dementia participating in a high-intensity functional exercise program in nursing homes: \u2018while it\u2019s tough, it\u2019s useful\u2019","volume":"12","author":"Lindeloef","year":"2017","journal-title":"PLOS ONE"},{"key":"key20210623091139587_ref1-bib49","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/1748-5908-6-42","article-title":"The behaviour change wheel: a new method for characterising and designing behaviour change interventions","volume":"6","author":"Michie","year":"2011","journal-title":"Implement Sci"},{"key":"key20210623091139587_ref1-bib50","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/s13012-017-0605-9","article-title":"A guide to using the theoretical domains framework of behaviour change to investigate implementation problems","volume":"12","author":"Atkins","year":"2017","journal-title":"Implement Sci"},{"key":"key20210623091139587_ref1-bib51","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/1471-2288-13-117","article-title":"Using the framework method for the analysis of qualitative data in multi-disciplinary health research","volume":"13","author":"Gale","year":"2013","journal-title":"BMC Med Res Methodol"},{"key":"key20210623091139587_ref1-bib52","doi-asserted-by":"crossref","first-page":"173","DOI":"10.4324\/9780203413081_chapter_9","volume-title":"Analyzing Qualitative Data","author":"Ritchie","year":"1994"},{"key":"key20210623091139587_ref1-bib53","volume-title":"Research Methods in Health: Investigating Health and Health Services","author":"Bowling","year":"2014","edition":"4th"},{"key":"key20210623091139587_ref1-bib54","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1002\/nau.20668","article-title":"Prevalence of urinary incontinence and associated risk factors in nursing home residents: a systematic review","volume":"28","author":"Offermans","year":"2009","journal-title":"Neurourol Urodyn"},{"key":"key20210623091139587_ref1-bib55","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1038\/nrurol.2013.143","article-title":"Neuromodulation for overactive bladder","volume":"10","author":"Bartley","year":"2013","journal-title":"Nat Rev Urol"},{"key":"key20210623091139587_ref1-bib56","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1007\/s00192-014-2359-0","article-title":"Transcutaneous posterior tibial nerve stimulation: evaluation of a therapeutic option in the management of anticholinergic refractory overactive bladder","volume":"25","author":"Ammi","year":"2014","journal-title":"Int Urogynecol J"},{"key":"key20210623091139587_ref1-bib57","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.maturitas.2020.02.008","article-title":"Effectiveness of transcutaneous tibial nerve stimulation at two different thresholds for overactive bladder symptoms in older women: a randomized controlled clinical trial","volume":"135","author":"Teixeira Alve","year":"2020","journal-title":"Maturitas"},{"key":"key20210623091139587_ref1-bib58","doi-asserted-by":"publisher","first-page":"186","DOI":"10.22037\/uj.v0i0.4169","article-title":"Pelvic floor muscle training with or without tibial nerve stimulation and lifestyle changes have comparable effects on the overactive bladder. A randomized clinical trial","volume":"15","author":"Bykoviene","year":"2018","journal-title":"Urol J"},{"key":"key20210623091139587_ref1-bib59","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.physio.2018.12.002","article-title":"A single-blind, randomized controlled trial to evaluate the effectiveness of transcutaneous tibial nerve stimulation (TTNS) in Overactive Bladder symptoms in women responders to percutaneous tibial nerve stimulation (PTNS)","volume":"105","author":"Martin-Garcia","year":"2019","journal-title":"Physiotherapy"},{"key":"key20210623091139587_ref1-bib60","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1002\/nau.23843","article-title":"Efficacy of transcutaneous stimulation of the posterior tibial nerve compared to percutaneous stimulation in idiopathic overactive bladder syndrome: randomized control trial","volume":"38","author":"Ram\u00edrez-Garc\u00eda","year":"2019","journal-title":"Neurourol Urodyn"},{"key":"key20210623091139587_ref1-bib61","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1002\/nau.23361","article-title":"Transcutaneous posterior tibial nerve electrostimulation with low dose trospium chloride: could it be used as a second line treatment of overactive bladder in females","volume":"37","author":"Abulseoud","year":"2018","journal-title":"Neurourol Urodyn"},{"key":"key20210623091139587_ref1-bib62","doi-asserted-by":"publisher","first-page":"E297","DOI":"10.5489\/cuaj.6142","article-title":"A randomized, controlled trial of transcutaneous tibial nerve stimulation to treat overactive bladder and neurogenic bladder patients","volume":"14","author":"Welk","year":"2020","journal-title":"Can Urol Assoc J"},{"key":"key20210623091139587_ref1-bib63","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1111\/j.1742-1241.2011.02763.x","article-title":"A healthy bladder: a consensus statement","volume":"65","author":"Lukacz","year":"2011","journal-title":"Int J Clin Pract"},{"key":"key20210623091139587_ref1-bib64","doi-asserted-by":"publisher","first-page":"1356","DOI":"10.1111\/j.1532-5415.1995.tb06614.x","article-title":"Functional incidental training, mobility performance, and incontinence care with nursing home residents","volume":"43","author":"Schnelle","year":"1995","journal-title":"J Am Geriatr Soc"},{"key":"key20210623091139587_ref1-bib65","doi-asserted-by":"publisher","first-page":"1476","DOI":"10.1046\/j.1532-5415.2002.50401.x","article-title":"Translating clinical research into practice: a randomized controlled trial of exercise and incontinence care with nursing home residents","volume":"50","author":"Schnelle","year":"2002","journal-title":"J Am Geriatr Soc"},{"key":"key20210623091139587_ref1-bib66","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1111\/j.1447-0594.2012.00875.x","article-title":"Systematic review of care intervention studies for the management of incontinence and promotion of continence in older people in care homes with urinary incontinence as the primary focus (1966\u20132010)","volume":"12","author":"Flanagan","year":"2012","journal-title":"Geriatr Gerontol Int"},{"key":"key20210623091139587_ref1-bib67","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1002\/nau.24343","article-title":"The development and validation of instruments to measure dignity-protective continence care for care-dependent older people in residential aged care facilities: a study protocol","volume":"39","author":"Ostaszkiewicz","year":"2020","journal-title":"Neurourol Urodyn"},{"key":"key20210623091139587_ref1-bib68","doi-asserted-by":"publisher","first-page":"20","DOI":"10.7748\/nop2006.03.18.2.20.c2414","article-title":"Continence problems in care homes: auditing assessment and treatment","volume":"18","author":"Mangnall","year":"2006","journal-title":"Nurs Older People"},{"issue":"16","key":"key20210623091139587_ref1-bib69","doi-asserted-by":"publisher","DOI":"10.3310\/hta24160","article-title":"Dementia Care Mapping to reduce agitation in care home residents with dementia: the EPIC cluster RCT","volume":"24","author":"Surr","year":"2020","journal-title":"Health Technol Assess"},{"key":"key20210623091139587_ref1-bib70","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1016\/S0022-5347(05)67284-9","article-title":"Non-invasive outcome measures of urinary incontinence and lower urinary tract symptoms: a multicenter study of micturition diary and pad tests","volume":"164","author":"Groutz","year":"2000","journal-title":"J Urol"},{"key":"key20210623091139587_ref1-bib71","volume-title":"Unit Costs of Health and Social Care 2013","author":"Curtis","year":"2013"}],"container-title":["Health Technology Assessment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2036969","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/publications\/hta25410\/hta25410.xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2036969","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,15]],"date-time":"2023-08-15T15:38:17Z","timestamp":1692113897000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/hta\/hta25410"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":71,"journal-issue":{"issue":"41","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["10.3310\/hta25410"],"URL":"https:\/\/doi.org\/10.3310\/hta25410","relation":{},"ISSN":["1366-5278","2046-4924"],"issn-type":[{"value":"1366-5278","type":"print"},{"value":"2046-4924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]},"assertion":[{"value":"This content has been made freely available to all.","name":"free","label":"Free to read"},{"value":"7-2017","name":"contractual_start_date","label":"Contractual start date","group":{"name":"article_history","label":"Article History"}},{"value":"7-2020","name":"editorial_review_begun","label":"Editorial review begun","group":{"name":"article_history","label":"Article History"}},{"value":"1-2021","name":"accepted_for_publication","label":"Accepted for publication","group":{"name":"article_history","label":"Article History"}}]}}