Nocturnal alarm therapy and enuresis: an evidence-based review

Detalhes bibliográficos
Autor(a) principal: Carneiro, Joana Pinto
Data de Publicação: 2017
Outros Autores: Menezes, Ana, Pinto, Sofia Correia
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.32385/rpmgf.v33i3.12162
Resumo: Introduction: Nocturnal enuresis is a common problem, affecting about 15% of children between the ages of five and six years. Different treatments have been studied in order to diminish the potentially stigmatizing impact of NE, both for the child and the family. These include nocturnal alarms and behavior modification affecting sleep. Aim: The aim of this review was to assess the evidence for the effectiveness of nocturnal alarms in the treatment of nocturnal enuresis. Methods: A bibliographic review of international databases was conducted, using the MeSH terms ‘Nocturnal enuresis’ AND ‘Clinical alarms’. We also consulted the Índex RMP database using the search terms Enurese noturna and Alarme. We selected meta-analyses, systematic reviews, randomized controlled trials, observational studies, and clinical guidelines written in Portuguese and English that were published between January 2005 and January 2015. The Oxford Centre for Evidence-Based Medicine criteria were used to establish the Level of Evidence (LE). Results: From a total of 52 articles found, nine met the inclusion criteria. These included three systematic reviews, three clinical trials, and three guidelines. Most studies found that NA is more beneficial than other non-pharmacologic options. When compared to desmopressin, the use of NA has shown equivalent effectiveness. Its use is associated with less risk of relapse and a better response when NE occurs due to diminished nocturnal bladder capacity. However, beneficial results take longer to appear with NA, parental collaboration is needed, and there is a risk of decreased adherence to this treatment. Clinical guidelines agree with the results of published trials. Discussion: Given the potential benefits of nocturnal alarms in the treatment of nocturnal enuresis (Level of Evidence 1, Strength of Recommendation A), the family doctor should consider this treatment for NE resistant to initial measures, thus avoiding the need for pharmacologic intervention or premature referral.
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spelling Nocturnal alarm therapy and enuresis: an evidence-based reviewAlarme noturno e enurese: uma revisão baseada na evidênciaNocturnal enuresisClinical alarmsEnurese noturnaAlarmeIntroduction: Nocturnal enuresis is a common problem, affecting about 15% of children between the ages of five and six years. Different treatments have been studied in order to diminish the potentially stigmatizing impact of NE, both for the child and the family. These include nocturnal alarms and behavior modification affecting sleep. Aim: The aim of this review was to assess the evidence for the effectiveness of nocturnal alarms in the treatment of nocturnal enuresis. Methods: A bibliographic review of international databases was conducted, using the MeSH terms ‘Nocturnal enuresis’ AND ‘Clinical alarms’. We also consulted the Índex RMP database using the search terms Enurese noturna and Alarme. We selected meta-analyses, systematic reviews, randomized controlled trials, observational studies, and clinical guidelines written in Portuguese and English that were published between January 2005 and January 2015. The Oxford Centre for Evidence-Based Medicine criteria were used to establish the Level of Evidence (LE). Results: From a total of 52 articles found, nine met the inclusion criteria. These included three systematic reviews, three clinical trials, and three guidelines. Most studies found that NA is more beneficial than other non-pharmacologic options. When compared to desmopressin, the use of NA has shown equivalent effectiveness. Its use is associated with less risk of relapse and a better response when NE occurs due to diminished nocturnal bladder capacity. However, beneficial results take longer to appear with NA, parental collaboration is needed, and there is a risk of decreased adherence to this treatment. Clinical guidelines agree with the results of published trials. Discussion: Given the potential benefits of nocturnal alarms in the treatment of nocturnal enuresis (Level of Evidence 1, Strength of Recommendation A), the family doctor should consider this treatment for NE resistant to initial measures, thus avoiding the need for pharmacologic intervention or premature referral.Introdução: A enurese noturna (EN) é um problema comum em idade pediátrica, atingindo cerca de 15% das crianças entre os cinco e os seis anos de idade. Pela sua elevada prevalência, várias modalidades terapêuticas têm surgido no sentido de atenuar o seu impacto, muitas vezes estigmatizante para a criança e família. Entre as opções disponíveis para o seu tratamento sobressai o alarme noturno (AN), tratamento comportamental com efeito condicionado a nível do sono. Objetivo: Rever a evidência científica existente quanto à eficácia do alarme noturno como opção terapêutica no tratamento da enurese noturna. Metodologia: Foi efetuada uma pesquisa bibliográfica nas principais bases de dados internacionais, utilizando os termos MeSH: Nocturnal enuresis AND Clinical alarms. Foi igualmente consultado o Índex RMP usando os termos de pesquisa (DeCS) “Enurese noturna” e “Alarme”. Como critérios de inclusão foram selecionados: meta-análises, revisões sistemáticas, ensaios clínicos aleatorizados, estudos observacionais e orientações clínicas, tendo sido incluídos artigos em língua inglesa e portuguesa, de janeiro de 2005 a janeiro de 2015. Para atribuição do nível de evidência (NE) foi utilizada a escala Oxford Centre for Evidence-Based Medicine 2011. Resultados: Depois de analisados os 52 artigos resultantes da pesquisa, foram incluídos nove artigos: três revisões sistemáticas, três estudos originais e três normas de orientação clínica. Na maioria da literatura analisada foi identificado benefício acrescido do AN quando comparado com as restantes terapêuticas não farmacológicas. Nos estudos que estabeleceram comparação com a desmopressina, o alarme noturno mostrou resultados equiparáveis, excetuando-se menor risco de recaída com o AN e melhor res-posta na EN com capacidade vesical noturna diminuída. Como aspetos menos positivos enumeram-se os resultados mais tardios do AN, a necessidade de colaboração por parte dos pais e o risco de menor adesão ao tratamento. No que respeita às orientações clínicas elaboradas por entidades reconhecidas, as recomendações são concordantes com os resultados dos restantes estudos. Discussão/Conclusão: Considerando os resultados promissores do alarme noturno (Nível de evidência 1, Força de recomendação A), importa que o médico de família considere a sua potencial indicação nos casos de EN resistentes às medidas iniciais, evitando-se a necessidade de intervenção farmacológica e/ou referenciação hospitalar precoce.Associação Portuguesa de Medicina Geral e Familiar2017-05-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.32385/rpmgf.v33i3.12162https://doi.org/10.32385/rpmgf.v33i3.12162Portuguese Journal of Family Medicine and General Practice; Vol. 33 No. 3 (2017): Revista Portuguesa de Medicina Geral e Familiar; 200-8Revista Portuguesa de Medicina Geral e Familiar; Vol. 33 Núm. 3 (2017): Revista Portuguesa de Medicina Geral e Familiar; 200-8Revista Portuguesa de Medicina Geral e Familiar; Vol. 33 N.º 3 (2017): Revista Portuguesa de Medicina Geral e Familiar; 200-82182-51812182-517310.32385/rpmgf.v33i3reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://rpmgf.pt/ojs/index.php/rpmgf/article/view/12162https://rpmgf.pt/ojs/index.php/rpmgf/article/view/12162/11340Direitos de Autor (c) 2017 Revista Portuguesa de Medicina Geral e Familiarinfo:eu-repo/semantics/openAccessCarneiro, Joana PintoMenezes, AnaPinto, Sofia Correia2024-09-17T12:00:08Zoai:ojs.rpmgf.pt:article/12162Portal AgregadorONGhttps://www.rcaap.pt/oai/openairemluisa.alvim@gmail.comopendoar:71602024-09-17T12:00:08Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Nocturnal alarm therapy and enuresis: an evidence-based review
Alarme noturno e enurese: uma revisão baseada na evidência
title Nocturnal alarm therapy and enuresis: an evidence-based review
spellingShingle Nocturnal alarm therapy and enuresis: an evidence-based review
Carneiro, Joana Pinto
Nocturnal enuresis
Clinical alarms
Enurese noturna
Alarme
title_short Nocturnal alarm therapy and enuresis: an evidence-based review
title_full Nocturnal alarm therapy and enuresis: an evidence-based review
title_fullStr Nocturnal alarm therapy and enuresis: an evidence-based review
title_full_unstemmed Nocturnal alarm therapy and enuresis: an evidence-based review
title_sort Nocturnal alarm therapy and enuresis: an evidence-based review
author Carneiro, Joana Pinto
author_facet Carneiro, Joana Pinto
Menezes, Ana
Pinto, Sofia Correia
author_role author
author2 Menezes, Ana
Pinto, Sofia Correia
author2_role author
author
dc.contributor.author.fl_str_mv Carneiro, Joana Pinto
Menezes, Ana
Pinto, Sofia Correia
dc.subject.por.fl_str_mv Nocturnal enuresis
Clinical alarms
Enurese noturna
Alarme
topic Nocturnal enuresis
Clinical alarms
Enurese noturna
Alarme
description Introduction: Nocturnal enuresis is a common problem, affecting about 15% of children between the ages of five and six years. Different treatments have been studied in order to diminish the potentially stigmatizing impact of NE, both for the child and the family. These include nocturnal alarms and behavior modification affecting sleep. Aim: The aim of this review was to assess the evidence for the effectiveness of nocturnal alarms in the treatment of nocturnal enuresis. Methods: A bibliographic review of international databases was conducted, using the MeSH terms ‘Nocturnal enuresis’ AND ‘Clinical alarms’. We also consulted the Índex RMP database using the search terms Enurese noturna and Alarme. We selected meta-analyses, systematic reviews, randomized controlled trials, observational studies, and clinical guidelines written in Portuguese and English that were published between January 2005 and January 2015. The Oxford Centre for Evidence-Based Medicine criteria were used to establish the Level of Evidence (LE). Results: From a total of 52 articles found, nine met the inclusion criteria. These included three systematic reviews, three clinical trials, and three guidelines. Most studies found that NA is more beneficial than other non-pharmacologic options. When compared to desmopressin, the use of NA has shown equivalent effectiveness. Its use is associated with less risk of relapse and a better response when NE occurs due to diminished nocturnal bladder capacity. However, beneficial results take longer to appear with NA, parental collaboration is needed, and there is a risk of decreased adherence to this treatment. Clinical guidelines agree with the results of published trials. Discussion: Given the potential benefits of nocturnal alarms in the treatment of nocturnal enuresis (Level of Evidence 1, Strength of Recommendation A), the family doctor should consider this treatment for NE resistant to initial measures, thus avoiding the need for pharmacologic intervention or premature referral.
publishDate 2017
dc.date.none.fl_str_mv 2017-05-01
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https://doi.org/10.32385/rpmgf.v33i3.12162
url https://doi.org/10.32385/rpmgf.v33i3.12162
dc.language.iso.fl_str_mv por
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dc.relation.none.fl_str_mv https://rpmgf.pt/ojs/index.php/rpmgf/article/view/12162
https://rpmgf.pt/ojs/index.php/rpmgf/article/view/12162/11340
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2017 Revista Portuguesa de Medicina Geral e Familiar
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2017 Revista Portuguesa de Medicina Geral e Familiar
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dc.publisher.none.fl_str_mv Associação Portuguesa de Medicina Geral e Familiar
publisher.none.fl_str_mv Associação Portuguesa de Medicina Geral e Familiar
dc.source.none.fl_str_mv Portuguese Journal of Family Medicine and General Practice; Vol. 33 No. 3 (2017): Revista Portuguesa de Medicina Geral e Familiar; 200-8
Revista Portuguesa de Medicina Geral e Familiar; Vol. 33 Núm. 3 (2017): Revista Portuguesa de Medicina Geral e Familiar; 200-8
Revista Portuguesa de Medicina Geral e Familiar; Vol. 33 N.º 3 (2017): Revista Portuguesa de Medicina Geral e Familiar; 200-8
2182-5181
2182-5173
10.32385/rpmgf.v33i3
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