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Real-world effectiveness of app-based treatment for urinary incontinence: a cohort study
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.ORCID iD: 0000-0003-4723-6152
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
2021 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 1, article id e040819Article in journal (Refereed) Published
Abstract [en]

Objectives: The efficacy of app-based treatment for stress urinary incontinence (SUI) has been demonstrated in a randomised controlled trial (RCT). In this study, we investigate the user characteristics and the effectiveness of the same app when freely available, and compare these results with the RCT.

Design: Prospective cohort study.

Participants: During a 17-month period, 24 602 non-pregnant, non-postpartum women older than 18 years downloaded the app and responded anonymously to a questionnaire. Of these, 2672 (11%) responded to the 3-month follow-up.

Intervention: Three months' use of the app Tat, containing information, a pelvic floor muscle training programme and lifestyle advice.

Main outcome measures: Change in symptom severity (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF)) and subjective improvement (Patient Global Impression of Improvement (PGI-I)).

Results: Of the respondents, 88% lived in Sweden and 75% (18 384/24 602) were incontinent with a mean age of 45.5 (SD 14.1) years. The UI types, based on symptoms, were SUI (53%), urgency UI (12%), mixed UI (31%) and undefined (4%). The mean ICIQ-UI SF score was 8.2 (SD 4.0) at baseline. The mean ICIQ-UI SF score reduction at follow-up was 1.31 (95% CI: 1.19 to 1.44) with a larger reduction in those with more severe incontinence at baseline (severe/very severe 3.23 (95% CI: 2.85 to 3.61), moderate 1.41 (95% CI: 1.24 to 1.59) and slight 0.24 (95% CI 0.06 to 0.42). When the results were weighted to match the distribution of severity in the RCT, the ICIQ-UI SF score reduction was 2.2 compared with 3.9 in the RCT. Regarding PGI-I, 65% experienced improvement compared with 92% in the RCT.

Conclusions: The app Tat was effective for self-management of UI even in the real world. Although the reduction in incontinence symptoms was less than in the RCT, two-thirds of the users improved. App-based treatment reaches many women without requiring resources from ordinary healthcare services.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2021. Vol. 11, no 1, article id e040819
Keywords [en]
urinary incontinences, urogynaecology, urology, gynaecology
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:umu:diva-180159DOI: 10.1136/bmjopen-2020-040819ISI: 000610057600008PubMedID: 33397664Scopus ID: 2-s2.0-85099045286OAI: oai:DiVA.org:umu-180159DiVA, id: diva2:1530445
Available from: 2021-02-22 Created: 2021-02-22 Last updated: 2023-08-28Bibliographically approved

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Rygh, PontusAsklund, InaSamuelsson, Eva

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