Use of a Digital Conversational Agent for the Management of Overactive Bladder

Abstract

Importance Conservative therapy is effective for the treatment of overactive bladder (OAB) but may be limited by accessibility to care. Objective The objective of this study was to evaluate the efficacy of a digital conversational agent (CeCe) for the treatment of OAB. Study Design This was a prospective observational trial utilizing a digital conversational agent developed by Renalis University Hospitals (Cleveland, Ohio) for the treatment of OAB. Patients were given access to CeCe over an 8-week period and were instructed on how to perform bladder training and pelvic floor exercises and taught about bladder health. The primary outcome was a decrease in the International Consultation on Incontinence—Overactive Bladder Quality-of-Life Questionnaire (ICIQ-OAB-QoL) score from week 1 to week 8. Patients also completed the 36-item Short-Form Health Survey and Generalized Anxiety Disorder Questionnaire at the same intervals and voiding diaries at weeks 1, 4, and 8. A power analysis was performed and determined that a total of 30 patients would be needed to demonstrate a significant difference in symptom scores after use of CeCe with 80% power and an α error of 5%. Results Twenty-nine patients completed all data collection. The ICIQ-OAB-QoL scores were significantly different between weeks 1 and 8 (62 [IQR], 49–75) vs 32 [IQR, 24–43]; P < 0.001). Patients also reported a decrease in frequency pretreatment and posttreatment (7 [IQR, 6–10] vs 5 [IQR, 4–7]; P = −0.04), nocturia (2 [IQR, 1–3] vs 1 [IQR, 1–2]; P = 0.03), and urge urinary incontinence (2 [IQR, 1–5] vs 0 [IQR, 0–3]; P = 0.04). Consumption of alcohol decreased from week 1 to week 8 (24 oz [IQR, 12–36 oz) to 14 oz (IQR, 9–22 oz]; P = 0.02). Conclusion The use of a digital conversational agent effectively reduced the severity of symptoms and improved quality of life in patients with OAB.