Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/25538
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dc.contributor.authorHagen, Suzanneen_UK
dc.contributor.authorSinclair, Lesleyen_UK
dc.contributor.authorCross, Stephenen_UK
dc.date.accessioned2018-05-09T22:38:54Z-
dc.date.available2018-05-09T22:38:54Z-
dc.date.issued2010en_UK
dc.identifier.otherCD004012en_UK
dc.identifier.urihttp://hdl.handle.net/1893/25538-
dc.description.abstractBACKGROUND: People requiring long-term bladder draining with an indwelling catheter can experience catheter blockage. Regimens involving different solutions can be used to washout catheters with the aim of preventing blockage.  OBJECTIVES: To determine if certain washout regimens are better than others in terms of effectiveness, acceptability, complications, quality of life and economics for the management of long-term indwelling urinary catheterisation in adults.  SEARCH STRATEGY: We searched the Cochrane Incontinence Group Specialised Trials Register, MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, CINAHL and EMBASE (searches last updated April 2009). Additionally, we examined all reference lists of identified trials.  SELECTION CRITERIA: All randomised and quasi-randomised trials comparing catheter washout policies (e.g. washout versus no washout, different washout solutions, frequency, duration, volume, concentration, method of administration) in adults (16 years and above) in any setting (i.e. hospital, nursing/residential home, community) with an indwelling urethral or suprapubic catheter for more than 28 days.  DATA COLLECTION AND ANALYSIS: Data were extracted by three reviewers independently and compared. Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook. If the data in trials were not fully reported, clarification was sought from the authors. For categorical outcomes, the numbers reporting an outcome were related to the numbers at risk in each group to derive an risk ratio (RR). For continuous outcomes, means and standard deviations were used to derive weighted mean differences (WMD). No meta-analysis of study results was possible.  MAIN RESULTS: Five trials met the inclusion criteria involving 242 patients (132 completed) in two cross-over and three parallel-group randomised controlled trials. Only three of the eight pre-stated comparisons were addressed in these trials. Some trials addressed more than one comparison (e.g. washout versus no washout and one type of washout solution versus another). The analyses reported for the two cross-over trials were inappropriate as they were based on differences between groups rather than differences within individuals receiving sequential interventions. Two parallel-group trials had limited value: one combined results for suprapubic and urethral catheters and one had data on only four participants. Only one trial was free of significant methodological limitations, but its sample size was small. Three trials compared no washout with one or more washout solution (saline or acidic solutions) and authors tended to conclude no difference in clinical outcomes between washout and no washout. In the one trial which had data of sufficient quality to allow interpretation, no difference was detected between washout and no washout groups in the rate of symptomatic urinary tract infection or time to first catheter change.  Three trials compared different types of solution: saline versus acidic solutions (two trials); saline versus acidic solution versus antibiotic solution (one trial). Authors tended to report no difference between different washout solutions but the data were too few to support their conclusions. The one trial which warranted consideration concluded no difference between saline and an acidic solution in terms of symptomatic urinary tract infections or time to first catheter change.  AUTHORS' CONCLUSIONS: The data from five trials comparing differing washout policies were sparse and trials were generally of poor quality or poorly reported. The evidence was too scanty to conclude whether or not washouts were beneficial. In the first instance we require further rigorous, high quality trials with adequate power to detect any benefit from washout being performed as opposed to none. Then trials comparing different washout solutions, washout volumes, frequencies/timings and routes of administration are needed.en_UK
dc.language.isoenen_UK
dc.publisherWiley-Blackwell for the Cochrane Collaborationen_UK
dc.relationHagen S, Sinclair L & Cross S (2010) Washout policies in long-term indwelling urinary catheterisation in adults. Cochrane Database of Systematic Reviews, 3, Art. No.: CD004012. https://doi.org/10.1002/14651858.CD004012.pub4en_UK
dc.rightsThis review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2010, Issue 3. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review. This is the reference to the original version of this review: Mooney J, Hagen S, Niel-Weise B. Washout policies for management of long-term voiding problems in catheterised adults (Protocol). The Cochrane Database of Systematic Reviews 2002, Issue 4. Art. No.: CD004012. DOI: 10.1002/14651858.CD004012. https://doi.org/10.1002/14651858.CD004012en_UK
dc.titleWashout policies in long-term indwelling urinary catheterisation in adultsen_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1002/14651858.CD004012.pub4en_UK
dc.identifier.pmid20238325en_UK
dc.citation.jtitleCochrane Database of Systematic Reviewsen_UK
dc.citation.issn1469-493Xen_UK
dc.citation.volume3en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.citation.date17/03/2010en_UK
dc.contributor.affiliationGlasgow Caledonian Universityen_UK
dc.contributor.affiliationInstitute for Social Marketingen_UK
dc.contributor.affiliationEast Cheshire NHS Trusten_UK
dc.identifier.isiWOS:000275717200009en_UK
dc.identifier.scopusid2-s2.0-77951245834en_UK
dc.identifier.wtid883847en_UK
dc.contributor.orcid0000-0002-2210-8181en_UK
dcterms.dateAccepted2010-03-17en_UK
dc.date.filedepositdate2017-06-26en_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorHagen, Suzanne|en_UK
local.rioxx.authorSinclair, Lesley|0000-0002-2210-8181en_UK
local.rioxx.authorCross, Stephen|en_UK
local.rioxx.projectInternal Project|University of Stirling|https://isni.org/isni/0000000122484331en_UK
local.rioxx.freetoreaddate2017-06-26en_UK
local.rioxx.licencehttp://www.rioxx.net/licenses/all-rights-reserved|2017-06-26|en_UK
local.rioxx.filenameHagen_et_al-2010-The_Cochrane_Library.pdfen_UK
local.rioxx.filecount1en_UK
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