A Randomized Controlled Trial Comparing Telemedicine Versus In-Person Office Visits for the Follow-Up of Overactive Bladder

Abstract

IMPORTANCEOveractive bladder is a condition that may be ideally suited for the use of telemedicine because initial treatment options are behavioral modification and pharmacotherapy.OBJECTIVEWe sought to evaluate if there was an overall difference in patient follow-up rates between telemedicine and in-person visits.STUDY DESIGNNew patients presenting with overactive bladder from July 2020 to March 2021 were randomized into telemedicine and in-person visits groups. A prospective database was maintained to compare follow-up rates, satisfaction rates, and time commitment.RESULTSForty-eight patients were randomized, 23 to the telemedicine group and 25 to the in-person visits group. There was no significant difference in follow-up rates between the telemedicine and in-person follow-up groups at 30 days (39% vs 28%, P = 0.41), 60-days (65% vs 56% P = 0.51) or 90 days (78% vs 60%, P = 0.17). There was no significant difference in satisfaction rates between the 2 groups. There was a significant difference between the average telemedicine visit time and in-person visit time (12.1 ± 6.9 minutes vs 22.8 ± 17.1 minutes; P = 0.02). For in-person visits, the average travel time was 49 minutes (interquartile range, 10–90 minutes) and average miles traveled was 22.1 miles (interquartile range, 10–70 miles).CONCLUSIONSThere was no significant difference in follow-up or satisfaction rates between telemedicine and in-person visits. Telemedicine visits took half the length of time compared with in-person visits. On average, patients in the telemedicine group saved approximately 1 hour per follow-up visit. Telemedicine visits save both the health care provider and patient significant amounts of time without sacrificing patient satisfaction and follow-up rates.

The Impact of an Overactive Bladder Care Pathway on Longitudinal Patient Management

“…In addition, a majority of study observations were before the COVID pandemic and more broad use of telehealth visits; implementation of telehealth follow-up is now more feasible and would be a useful extension of OAB care pathway implementation. 18 Also, socioeconomic status and level of education were not captured and could influence a patient's ability or willingness to proceed to second or third-line therapies. Finally, the study electronically abstracted medication prescriptions without the ability to determine whether prescriptions were filled or taken, and thus could not assess patient adherence to therapy.…”

“…Furthermore, this study did not capture the number of patient communications outside of the office visit setting, which are a key component of the care pathway that facilitate progress along the pathway and patient convenience by preventing the need to return for multiple visits, an advantage of the pathway especially given the distance traveled by many of our patients. In addition, a majority of study observations were before the COVID pandemic and more broad use of telehealth visits; implementation of telehealth follow-up is now more feasible and would be a useful extension of OAB care pathway implementation 18 . Also, socioeconomic status and level of education were not captured and could influence a patient's ability or willingness to proceed to second or third-line therapies.…”

Digital health innovations in urology: telemedicine, wearables, and mobile applications – a systematic review of literature

“…Sassani et al [17] also discovered that preoperative counseling via telephone was equivalent to office visits for preparing patients for POP surgery. Mossack et al [18] determined if there was a significant difference in patient follow-up rates between telemedicine and in-person visits for newly diagnosed patients with overactive bladder (OAB). There was no significant difference between telemedicine and in-person visits in terms of follow-up or patient satisfaction.…”

Utilization of Telemedicine during COVID-19 in Saudi Arabia: A Multicenter Study

“…Further, reduced in-person interaction was one of telemedicine's most frequently reported drawbacks [ 8 ]. However, a randomized controlled trial comparing in-person vs. telemedicine for follow-up visits for overactive bladder with 48 patients showed no significant difference between the group in terms of patient satisfaction [ 9 ], and in terms of cost-effectiveness, it reduces the overall cost compared to in-person-based care [ 10 ].…”