Lower urinary tract symptoms (LUTS) are common in older adults, yet often unrecognized.  Most older adults visit their community pharmacy frequently and may purchase bladder products or receive prescriptions that impact bladder health. Pharmacists in many jurisdictions are able to engage in assessment and prescribing activities, which may provide a resource for older adults in the community living with LUTS.  The purpose of this project was to evaluate the impact of pharmacist identification and initial management on LUTS in older adults.

Design: Randomized controlled trial. 
Setting: Community pharmacies in the province of Alberta, Canada.
Population: Any patient over the age of 60 who is presenting with any LUTS (measured by 3 validated screening questions). 
Intervention: All enrolled patients completed an initial online questionnaire including demographics, description of LUTS, and scored 3 validated tools regarding bladder symptoms (Patient Perception of Bladder Condition (PPBC), Bladder Self Assessment Questionnaire (B-SAQ), and International Consultation on Incontinence – Short Form (ICI-Q SF)). After completion, the pharmacist reviewed the questionnaire and electronic records. For patients in the intervention group, the pharmacist followed up with the patient at 4 and 8 weeks and consulted with the patient on strategies to minimize LUTS. Patients who were randomized into the control group received usual care with no specific intervention. 
Primary Outcome: Change in PPBC from baseline to the last follow-up visit.

We conducted a preliminary analysis of the data for 25 patients who have completed the study. There were 12 patients randomized into the intervention group and 13 in the control group. PPBC scores on average was decreased by 0.2 in the intervention group and 0.5 in the control group. Symptom and bother scores in the intervention group decreased by 0.2 and 0.5 respectively, compared to the control group where there was no change in symptom score and a decrease of 0.4 in bother score. The greatest difference was seen when comparing ICIQ scores, in which the intervention group showed an average decrease of 0.8, whereas the control group had a decrease of 0.3.

This preliminary analysis indicates that pharmacists are able to engage in assessment and intervention of LUTS with the potential to improve measures of urinary incontinence.  This analysis was not powered to detect differences, but it is important to note that there are slight expected improvements in the control group, typical of randomized clinical trials.  There is a positive trend noted that symptom and bother scores also improved in the intervention group.

Enrolling patients in a pharmacist intervention study improves perception of LUTS symptoms.