Incontinence and bladder weakness can be isolating conditions because they still cause embarrassment. Yet at least three million adults in the UK suffer from incontinence, including one in five women over 40, and over-active bladder affects one in eight of us, according to The Urology Foundation. Urinary incontinence and urinary problems are thought to cost the NHS about £26m a year.
Incontinence is not just an old person’s condition. About 45 per cent of new mums are affected by it and, according to Mintel research (January 2019), 40 per cent of people aged 16 to 34 experience it in some form. It is more common among women – Mintel says 43 per cent have some experience of it – but 37 per cent of men also suffer. It does get more common with age, says Mintel, with 54 per cent of women aged 65-plus experiencing it, along with 39 per cent of men.
The incontinence customer
|There isn't a single typical customer. Here are the groups you are most likely to come across|
|The first time customer||“They will often be reluctant to admit they have problem,” says Ms Myers. “It may be a pregnant woman or a new mum, a menopausal woman or a man with a prostate problem. You need to consider their emotional needs, too, and be tactful and aware of the language you use and know the right questions to ask.”|
|The care giving relative||This is a customer coming in to buy incontinence products for someone they are caring for. “It’s vital to ask the right questions because they are not the end user,” says Ms Myers. “Find out what medical conditions the user has. For example, do they have dementia?”|
|The top up shopper||This is a customer who gets their products on prescription, but who comes in for extra supplies. “This is a good opportunity to tell them about the range of products that are available, as they may not be aware of how quickly products are developing,” says Ms Myers.|
|The elderly shopper||This customer uses heavy duty products in large pack sizes and may struggle to carry these, but doesn’t shop online. “Pharmacy shelf space is limited, so you won’t have space to display large packs,” says Ms Myers. “Use point of sale to signal that you do keep large packs in your stock room and can offer home delivery.”|
“Incontinence is a significant problem in the UK, partly fuelled by the ageing population, which brings incontinence care needs,” says Lisa Myers, TENA marketing manager at Essity. “Also, the increase in prostate problems in men, including cancer, has played a role. Pregnancy is a significant factor and menopause is another key trigger.”
It seems many sufferers are still not seeking help for the issue. “It is essential that patients are aware of the risk of leaving their little leaks untreated,” says Hayley Green, content project co-ordinator at Savantini. “There are many treatments available for incontinence, but only 60 per cent seek treatment and 50 per cent of those continue to suffer from incontinence as a result of not wanting to return to their GP for further support when initial treatments fail.
”Pharmacy is perfectly placed to help customers with this sensitive issue, says pharmacist Ade Williams at Bedminster pharmacy in Bristol. “The professional, discreet and knowledgeable environment we offer is not just about product purchase, but offers the opportunity to look at underlying causes and offer advice on lifestyle changes, too,” he says.
Numark pharmacy services manager Lucy Morris agrees. “Going to a local community pharmacy is a much more personal experience for those who need support with bladder weakness than going to a supermarket or buying online,” she says.
There have been big changes in the incontinence market in the past few years, including the launch of underwear products that are not only more discreet and effective, but look like normal briefs. We’ve seen this with the launch of TENA Silhouette Noir pants, the first black incontinence pants with a low waist, which are designed to help normalise the condition.
“We need to get away from the old image of incontinence products as medical aids,” says Ms Myers. “Consumers still want to feel feminine and sexy. We are offering women more discreet products, such as Silhouette Noir, which mirrors trends in fashion. Some 82 per cent of women own black underwear and 53 per cent wear it most of the time. It’s about giving women choice.”Advertising has included showing women aged 40-plus wearing the pants, which is helping to raise the profile of incontinence.
The growth of gender-specific products is a big trend and we're moving away from unisex products
Always Discreet Boutique pants come in several colours with lacy prints, so they look and feel like normal underwear. Depend Active-Fit underwear has been redesigned to provide discreet and comfortable protection while women are exercising and has a low waist and cotton-like fabric.
“Both men and women favour dark coloured underwear,” says Ms Green. “We are looking to expand our range of incontinence underwear to include more feminine fits as well.”
“Women want to wear fashionable, on-trend clothes and find this difficult with some of the existing products,” says Alex Shaw, UK marketing manager for Ontex Global. “They are worried people will notice bulky incontinence products and want to use ones that resemble their normal underwear. Customers want performance and comfort, but most importantly they want to feel normal.”
Its iD Intime range is designed to look and feel like normal underwear and features cotton-like fabric, feminine details and advanced odour control.
“Training for staff is vital, but so is being aware of the uncommon prompts and underlying causes of incontinence,” says Mr Williams. “You need to be able to communicate in a sensitive, informed, but discreet manner. For example, being able to raise enquiries discreetly when you see post-menopausal customers buying large quantities of sanpro products, but you need good product knowledge as the cost of incontinence products can be a barrier.”
“Embarrassment is common and we always respect customer privacy, but where appropriate we advise customers that they are not the only ones encountering this health concern,” says Ms Paul. “But knowing it is a common problem does reassure them.”
“Often patients suffering from incontinence may not be talking about it and be managing it inadequately,” says Ms Morris. “Pharmacists can open up conversations during services such as MURs, which may establish issues such as incontinence and help improve a patient’s management of their condition.”
Essity provides advice cards that you can give to customers who find talking difficult. “Always suggest using your consultation room if they seem embarrassed,” says Ms Myers. “It’s essential to make their experience more comfortable.”
Ms Green suggests promoting the statistics around incontinence to help normalise it. “Incontinence is very common, but it is not normal and can be avoided or treated with some relatively simple solutions,” she says. She also suggests providing leaflets for customers.
Ontex Global has a new e-learning module for pharmacists, based on shopper research and the emotional effects of incontinence. “We cover how to advise and tackle sensitive issues,” says Mr Shaw.
Some customers will find the topic so awkward that they will pretend to be buying for or asking advice on behalf of a friend or relative. While this needs careful handling, it need not be a barrier to providing good advice, says Mr Williams. “It can actually make exploring and obtaining details of the underlying causes easier,” he says.
Ms Paul says this is a common occurrence in her pharmacy. “It’s important to remain professional, even when it’s quite clear the person is referring to their own problems,” she says. “I try to put the customer at ease. What I’ve noticed is that by building up a rapport with your customers they will start to open up more. In a recent encounter I had a customer actually clarify that it was their own health issue and not someone else’s.”
Ms Morris has also come across this. “There is no real need to establish if the customer is pretending to buy for someone else, but it’s important to ensure the questions asked obtain the information needed for appropriate advice on products and alternative solutions,” she says.
According to Essity, the fastest growing segment of the market is men, up by 25 per cent (IRI) this year. “This is thanks to growing awareness of male incontinence, which we’ve worked hard to increase because it’s still not a topic men want to discuss,” says Ms Myers. “Gender-specific products is a big trend and we’re following the US in moving away from unisex products now.”
Essity recently relaunched its men’s range. “We wanted these to look and feel like other men’s grooming products, not medical products,” says Ms Myers. “We now have our best ever absorbency and a slimmer design, which fits a man’s body better, and odour-neutralising technology to give men more confidence.”
Last year Essity ran an initiative with Durham County Cricket Club, where it supplied sanitary disposal bins in men’s toilets. “These proved really popular and they helped raise the profile of men’s incontinence, too,” says Ms Myers.
According to Mintel, there is plenty of potential to grow the men’s market, as 57 per cent of men who experience incontinence don’t use any products.
Mr Williams says you can expect customers to have their own views on the cause of their incontinence. “Be willing to explore and listen, but also correct some wrong beliefs, such as needing to limit fluid intake to control it,” he says. “Also, be aware of what medication they might be on, such as diuretics, which will play a role.”
Pamela Paul, Alphega pharmacist at Priory community pharmacy in Dudley, says: “Some customers will be depressed about their situation and it will be clear it’s having an impact on their confidence and quality of life. Others will ask if we have any medication to prevent or control it.”
Kellaway Pharmacy, Bristol
Shaftesbury Pharmacy, Harrow
Well Pharmacy, Hartlepool
|“This is an important category for us because we are in an area with a large elderly population. They come in and ask our advice about products. There is a lot of choice and it can be confusing. We sell mainly TENA products, which are very popular. In the past year or so we’ve noticed more men coming in. Advertising and the introduction of male-specific products has helped. Our female customers like the new, more feminine products. It’s a good idea to offer samples if you can, as dexterity and lifestyle are important in whether a specific product will suit them.”||“This is a vital category for us. We’ve given it the prime location in our store. No one wants to ask where the incontinence products are. Discretion is essential. It’s important customers can browse products without having to speak to anyone unless they want to. If they do ask questions, they are usually about absorption, ease of use, how discreet they are. They want to know how effective the underwear is compared to pads. Packaging is so much clearer these days and this really helps customers. Our best seller for men and women is TENA, but for just women it’s Always.”||“This is a massive category for us and one of our top three sectors. Typical queries are from post-partum women and the elderly. TENA has a huge range and provides samples customers can try, giving staff the opportunity to guide them on the best product. TENA displays categorise products, which is brilliant for customers. We site our display in a highly visible area, but away from busier parts of the store so customers can browse comfortably. More customers are aware of this fast-growing category creating huge opportunities as trained pharmacy teams can give expert advice.”|