Date of Award

2019

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

Laura Levy, DHSc, PA-C

Abstract

OBJECTIVE: The objective of this selective evidence based medicine (EBM) review is to determine whether or not “Is electroacupuncture effective in improving quality of life for women with urinary incontinence?”

STUDY DESIGN: A systematic review of 3 peer-reviewed studies published between the years of 2014 and 2017.

DATA SOURCES: Two randomized placebo-controlled studies and one comparative study evaluating if electroacupuncture (EA) and/or the use of tolterodine improves the quality of life and therapeutic effects of those with urinary incontinence (UI). Sources were selected from PubMed and Cochrane Library based off of their relevance to the clinical question and the outcomes being patient oriented.

OUTCOME(S) MEASURED: The outcomes measured depended on the study, although all were patient oriented. Quality of life was measured through The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), whereas evaluation of therapeutic effects and UI severity were self-reported.

RESULTS: The study conducted by Lui Z, Liu Y, Xu H, et al.,1 showed statistically significant improvement of quality of life (95% CI, p<0.001), as well as reduction of UI symptoms depicted by self-reported SUI severity (p=0.03), and evaluation of therapeutic effects (p<0.001). The study conducted by Xu H, Liu B, Wu J, et al.,2 revealed statistically significant results as well with the self-evaluation of therapeutic effect having a p-value of <0.001, and quality of life having a p-value=0.001. Lastly, the study conducted by Jin C, Zhou X, Pang R3 had a statistically significant result for quality of life (p<0.001), indicating that both groups responded to their respective treatment. At the end of week 8, there was no difference of patient-reported improvement between groups, indicating that tolterodine didn’t provide additional benefit.

CONCLUSIONS: The evidence presented in this review reveals that there is satisfactory data to conclude that EA improves the quality of life of women who have UI. This review also indicates that tolterodine doesn’t provide additional benefit of UI symptoms. Further research is warranted to evaluate symptom improvement from EA compared to traditional pelvic floor training exercises.

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