Leeds Older women Urinary Incontinence Self-Management (LOUISA)



To develop, implement and evaluate an evidence-based self-management package for older women suffering from urinary incontinence.


The Medical Research Council (MRC) framework for the development and evaluation of complex interventions has been used to guide the study design. There are two phases in this study.

• Phase 1 an evidence synthesis and stakeholder interviews aiming to develop the initial prototype of the self-management intervention.

• Phase 2: feasibility and acceptability of the self-management intervention.


Urinary incontinence remains a largely underreported and underdiagnosed health problem due to cultural norms of privacy and feelings of embarrassment. In the UK, it is estimated that 5.15 million people suffer from some degree of urinary incontinence, which is comparable to the prevalence of asthma (5.4 million). Urinary incontinence has been found to be of high priority to older women, as the prevalence increases significantly with age and tends to be more common in women due to the effects of childbirth and the menopause.

Despite such high prevalence estimates, only about 30% of women with urinary incontinence had ever consulted a doctor in western countries such as France, Germany, Spain and the UK. The main reasons for many sufferers not accessing medical care include feeling embarrassed to discuss with others, poor awareness or low expectations of treatments, and perceiving urinary incontinence as an inevitable consequence of ageing. Instead, individuals try to cope with their condition largely on their own, with variable success. Therefore self-management is considered to be valuable as a means of coping with urinary incontinence. Many self-management interventions have also been developed worldwide to support patients with a range of long term conditions. However older women with urinary incontinence remain a neglected group, not only because it is a hidden problem, but also knowledge, confidence and skills of older women for self-management may decrease with age. Such a gap between evidence and practice reveals the need to develop and promote self-management interventions tailored for older women who suffer with urinary incontinence.


Dr Yu (Maggie) Fu, Dr Zoe Darwin, Professor Andrea Nelson, Professor Linda McGowan

Funding body

Leeds Benevolent Society for Single Ladies (LBSSL) (Registered charity)


Dr Yu (Maggie) Fu, Y.Fu@leeds.ac.uk