Urinary Incontinence in Indian Women in Leicester

Background: Urinary incontinence affects people of different ages, gender and ethnic backgrounds. Current review of literature shows very that very little work has been done with regards to urinary incontinence in ethnic minority groups. At Leicester there is a high ethnic minority population comprising of different ethnic groups, the largest in inner city Leicester being the Indians that migrated from the state of Gujarat in India. Observations of clinic attendees, and unpublished data from the Medical Research Council Leicester Incontinence Study, lead us to believe that significant numbers of Indian women have continence problems but do not make use of currently available services. Aims: To explore inequality in health, barriers towards accessing continence care and to further understand how best to provide continence services to this group the research program was formulated comprising of: Prevalence study, Cultural context study, Patients‘ journey through primary care study. These will address the various aspects of the influence and interaction of ethnic origin with incontinence care. Methods: This project uses a mixed method approach combining both quantitative and qualitative research methods. The quantitative arm of the study uses validated self administered questionnaires to determine the prevalence and quality of life scores in women suffering with urinary incontinence in the community. The qualitative arm of the study uses focus groups and interviews to further explore women‘s coping strategies, the effect of migration in their symptoms and help seeking behaviour, the impact incontinence has on their lives and their attitudes towards available continence care, including suggestions for improving services. Results: The South Asian named women in our research reported higher rates and severity of urinary symptoms, with a corresponding greater impact on their quality of life when compared to White British named women and Indian women in Gujarat. It highlights some of the barriers in effective continence care. None of these women were referred to secondary care immediately, unlike their White British counterparts within the same primary care setup. Management of incontinence in primary care is inadequate and doesn‘t comply with the recommendations made in the NICE guidelines. Conclusions: This research project is a unique opportunity to study the impact of ethnic origin upon urinary incontinence. The inequalities in healthcare that have been highlighted together with the suggestions of service improvement that have come from the service users has resulted in the development of a strategic framework of continence care for ethnic minority women. This will aim to ensure accessible and acceptable care for these patients.