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Real-world effectiveness of app-based treatment for urinary incontinence: a cohort study
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.ORCID-id: 0000-0003-4723-6152
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
2021 (Engelska)Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 11, nr 1, artikel-id e040819Artikel i tidskrift (Refereegranskat) 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.

Ort, förlag, år, upplaga, sidor
BMJ Publishing Group Ltd, 2021. Vol. 11, nr 1, artikel-id e040819
Nyckelord [en]
urinary incontinences, urogynaecology, urology, gynaecology
Nationell ämneskategori
Urologi och njurmedicin
Identifikatorer
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
Tillgänglig från: 2021-02-22 Skapad: 2021-02-22 Senast uppdaterad: 2023-08-28Bibliografiskt granskad

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Rygh, PontusAsklund, InaSamuelsson, Eva

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