Determining the variables associated to clean intermittent self-catheterization adherence rate: one-year follow-up Study

Purpose: To determine adherence rate and variables associate with patients' adherence to Clean Intermittent Self Catheterization (CISC). Materials and Methods: Patients refereed to CISC training program between July 2006 and May 2008, were prospectively evaluated with urodynamic, 3 days bladder diary (BD) and WHOQoL-bref questionnaire. After training to perform CISC, patients were evaluated at 2 weeks, monthly for 6 months and at 12 months with clinical visits and BD. Patients were considered adherent if they were performing at least 80% of the initial recommendation. Results: Sixty patients (50.4 +/- 19.9 years old) were trained to perform CISC (21 female and 39 male). Out of them, 30 (50%) had neurogenic and 30 (50%) had a non-neurogenic voiding dysfunction. The adherence rate at 6 and 12 months was 61.7%, 58%, respectively. Patients < 40 years old had adherence rate of 86%. Women and neurogenic patients had higher adherence rate than their counterparts (p = 0.024 and p = 0.016, respectively). In the WHOQoL-bref, patients that adhere to the program had a significant higher score on psychological and social relationships domains. There was not difference in pre and post training WHOQoL-bref scores. Educational background, marriage status, detrusor leak point pressure, Bladder Capacity, number of leakage episodes did not play a role on the adherence rate. Conclusion: Patients in CISC program present a reasonable adherence after one year. Women, neurogenic voiding dysfunction and patients under 40 years old were significantly more adherents. The psychological and social relationship status seems to positively interfere on adherence. CISC did not affect patient's QoL evaluated by WHOQoL-bref.