Mobile app for treatment of stress urinary incontinence: A randomized controlled trial

Asklund, Ina; Nyström, Emma; Sjöström, Malin; Umefjord, Göran; Stenlund, Hans; Samuelsson, Eva

doi:10.1002/nau.23116

Cited by 140 publications

(332 citation statements)

References 21 publications

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“…These studies differ from ours in terms of treatment comparison (either a group receiving postal information or a group receiving postponed treatment, rather than comparison to usual care). 5,6 The main strength of this study will be in the combination of research methods used. A mixed-methods study design is frequently used in social science and can make an important contribution to RCTs evaluating health service interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the use of an app-based treatment for stress UI was assessed in Swedish women in a community setting, and not only produced clinically relevant symptom improvement but also reduced pad usage compared with postponed treatment. 5 In other research, an internet-based training program was shown to be a cost-effective alternative for treating stress UI when compared with a treatment program sent by post. 6 However, studies evaluating app-based treatment for all three types of UI (ie, stress, urgency, and mixed UI) are lacking, and app-based treatment for UI has never been compared to care as usual.…”

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confidence: 96%

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The impact of a mobile application‐based treatment for urinary incontinence in adult women: Design of a mixed‐methods randomized controlled trial in a primary care setting

Loohuis

Wessels

Jellema

et al. 2018

Neurourology and Urodynamics

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Aims:We aim to assess whether a purpose-developed mobile application (app) is non-inferior regarding effectiveness and cost-effective when used to treat women with urinary incontinence (UI), as compared to care as usual in Dutch primary care. Additionally, we will explore the expectations and experiences of patients and care providers regarding app usage. Methods: A mixed-methods study will be performed, combining a pragmatic, randomized-controlled, non-inferiority trial with an extensive process evaluation. Women aged ≥18 years, suffering from UI ≥ 2 times per week and with access to a smartphone or tablet are eligible to participate. The primary outcome will be the change in UI symptom scores at 4 months after randomization, as assessed by the International Consultation on Incontinence Modular Questionnaire UI Short Form. Secondary outcomes will be the change in UI symptom scores at 12 months, as well as the patient-reported global impression of improvement, quality of life, change in sexual functioning, UI episodes per day, and costs at 4 and 12 months. In parallel, we will perform an extensive process evaluation to assess the expectations and experiences of patients and care providers regarding app usage, making use of interviews, focus group sessions, and log data analysis. Conclusion: This study will assess both the effectiveness and cost-effectiveness of app-based treatment for UI. The combination with the process evaluation, which willThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 96%

The impact of a mobile application‐based treatment for urinary incontinence in adult women: Design of a mixed‐methods randomized controlled trial in a primary care setting

Loohuis

Wessels

Jellema

et al. 2018

Neurourology and Urodynamics

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“…The trial was registered at clinicaltrials.gov (ID: NCT01848938), and the trial results were described in detail elsewhere [14]. …”

Section: Methodsmentioning

confidence: 99%

Mobile App for Treatment of Stress Urinary Incontinence: A Cost-Effectiveness Analysis

Sjöström¹,

Lindholm²,

Samuelsson³

2017

J Med Internet Res

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BackgroundMobile apps can increase access to care, facilitate self-management, and improve adherence to treatment. Stress urinary incontinence (SUI) affects 10-35% of women and, currently, an app with instructions for pelvic floor muscle training (PFMT) is available as first-line treatment. A previous randomized controlled study demonstrated that the app benefitted symptom severity and quality of life (QoL); in this study we investigate the cost-effectiveness of the app.ObjectiveThe objective of this study was to evaluate the health economy of the app for treating SUI.MethodsThis deterministic cost-utility analysis, with a 1-year societal perspective, compared the app treatment with no treatment. Health economic data were collected alongside a randomized controlled trial performed in Sweden from March 2013 to October 2014. This study included 123 community-dwelling women participants of 18 years and above, with stress urinary incontinence ≥1 time per week. Participants were self-assessed with validated questionnaires and 2-day leakage diaries, and then randomized to 3 months of treatment (app group, n=62) or no treatment (controls, n=61). The app focused on pelvic floor muscle training, prescribed 3 times daily. We continuously registered treatment delivery costs. Data were collected on each participant’s training time, incontinence aids, and laundry at baseline and at a 3-month follow-up. We measured quality of life with the International Consultation on Incontinence Modular Questionnaire on Lower Urinary Tract Symptoms and Quality of Life, and calculated the quality-adjusted life years (QALYs) gained. Data from the 3-month follow-up were extrapolated to 1 year for the calculations. Our main outcome was the incremental cost-effectiveness ratios compared between app and control groups. One-way and multiway sensitivity analyses were performed.ResultsThe mean age of participants was 44.7 years (SD 9.4). Annual costs were €547.0 for the app group and €482.4 for the control group. Annual gains in quality-adjusted life years for app and control groups were 0.0101 and 0.0016, respectively. Compared with controls, the extra cost per quality-adjusted life year for the app group ranged from −€2425.7 to €14,870.6, which indicated greater gains in quality-adjusted life years at similar or slightly higher cost.ConclusionsThe app for treating stress urinary incontinence is a new, cost-effective, first-line treatment with potential for increasing access to care in a sustainable way for this patient group.

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“…Samuelsson et al presented a smartphone application as an easily accessible, cost effective treatment for stress urinary incontinence (SUI) and they were awarded joint winner of the Conservative Management Award. Given that many are still smartphone illiterate and 40% perform pelvic floor exercises incorrectly this application can provide an adjunct to, rather than replace, individualized pelvic floor training with digital palpation (Abstracts 16, 521, 526).…”

Section: Introductionmentioning

confidence: 99%

What was hot at the ICS meeting 2015

Hainsworth

Igualada-Martinez

Koch

et al. 2016

Neurourol. Urodynam.

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Mobile app for treatment of stress urinary incontinence: A randomized controlled trial

Abstract: The mobile app treatment was effective for women with SUI and yielded clinically relevant improvements. This app may increase access to first-line treatment and adherence to PFMT.

Cited by 140 publications

References 21 publications

The impact of a mobile application‐based treatment for urinary incontinence in adult women: Design of a mixed‐methods randomized controlled trial in a primary care setting

The impact of a mobile application‐based treatment for urinary incontinence in adult women: Design of a mixed‐methods randomized controlled trial in a primary care setting

Mobile App for Treatment of Stress Urinary Incontinence: A Cost-Effectiveness Analysis

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