PRIME: Pharmacy Role In the proMotion of continence


National Institute for Health and Care Research (NIHR) Research for Patient Benefit (RfPB) Ref.NIHR202212.

What’s the research question?

What do service users and providers think about a community pharmacy-based intervention for incontinence, what would the service consist of, and what is the evidence to underpin the development of such a service?

What is the problem?

Bladder and bowel incontinence (any accidental leakage) are difficult to discuss making it hard to get treatments that can help. There are many causes for these symptoms, so not surprisingly over one third of the UK adult population are affected. Living with incontinence can be distressing and seriously reduce a person’s quality of life. Sadly, people often do not seek help because they are embarrassed and believe that ‘nothing can be done’. However, treatments are available that can help improve symptoms in many cases.

What is the aim of the research?

We talked to people living with bladder and bowel symptoms about what would help them. They suggested that people experiencing incontinence need to know more about advice and treatments available. They also thought community pharmacies would be a good place for this as people often go there to buy continence-related products, such as pads. Pharmacies are also generally seen as more informal and convenient places to visit to get healthcare advice.

We believe much more could be done in community pharmacies to help more people find out about self-help to improve their symptoms.

How will this be achieved?

This study will bring together pharmacists and healthcare staff involved in providing bladder and bowel services, and people who use them to explore the possibilities for community pharmacies to provide a service for promoting bladder and bowel health. We will:

  • Explore what community pharmacies already do to help people manage bladder and bowel symptoms by reviewing what is already known and carrying out a national survey of pharmacies,
  • Gather opinions from healthcare staff and people who would use potential services via group discussions and one-to-one interviews,
  • Develop a Pharmacy Bladder and Bowel Service, with people who are likely to use the service and those who will be involved in providing it, by working through all the potential issues and considering what a successful service would look like,
  • Work out what we will need to measure to understand if the service is making a difference.

Patients, carers and the public have told us alternative approaches are needed to enable people with incontinence to avoid suffering in silence. Their input is key to this project and they will be directly involved in shaping it, understanding the findings and helping to communicate them. Support services need to be co-designed by people who live with incontinence to ensure it will meet their needs, and pharmacy staff to ensure the service can realistically be delivered.

This first stage will provide a plan for a Pharmacy Bladder and Bowel Service for a future project to see how useful continence care awareness in community pharmacies can be. Reaching a wider group of people in our communities who experience incontinence would be valuable to improving healthcare and improving patients’ lives.

Who is leading the research?

Prof Nikki Cotterill, Professor of Continence Care, School of Health and Social Wellbeing, Centre for Health and Clinical Research, University of the West of England.

Further information:

About this research

For more information or to get involved in this project, please contact

The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.