Defining the components of a self-management programme for men with uncomplicated lower urinary tract symptoms: a consensus approach.

OBJECTIVE: To define the components of a self-management programme of lifestyle and behavioural interventions for symptom control in men with uncomplicated LUTS. The use of lifestyle and behavioural interventions for symptom control in men with uncomplicated LUTS is widespread in the UK, however the effectiveness of these interventions has never been formally evaluated. Defining the components of a self-management programme will allow effectiveness studies to take place. MATERIALS AND METHODS: An eight member multidisciplinary panel rated 94 items for their appropriateness to be incorporated into the self-management programme using The Research and Development Appropriateness Method--RAM (UCLA). The item list was developed using semi-structured interviews with health care professionals and a national UK practice survey. RAM is a formal consensus process where an expert panel rate items over two rounds. The first round is conducted by post and in the second round the panel meets to discuss their initial ratings chaired by an independent moderator, then a second and final vote is made. RESULTS: The panel agreed that 57 of the original 94 items were appropriate to be incorporated in the self-management programme. These interventions were contained within the following categories: patient assessment prior to starting a self-management programme (6), education and reassurance (4), fluid management (6), caffeine (4), alcohol (2), concurrent medication (2), types of toileting (2), bladder re-training (15), miscellaneous (1), and implementation of a self-management programme (15). CONCLUSIONS: The components of a self-management programme of lifestyle and behavioural interventions for men with uncomplicated LUTS has been defined using the RAM consensus process. Now this problem of definition has been overcome, the effectiveness of self-management can be formally explored.