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One year effectiveness of an app‐based treatment for urinary incontinence in comparison to care as usual in Dutch general practice: A pragmatic randomised controlled trial over 12 months
Author(s) -
Loohuis Anne MM,
Van Der Worp Henk,
Wessels Nienke J,
Dekker Janny H,
SliekerTen Hove Marijke CPh,
Berger Marjolein Y,
Vermeulen Karin M,
Blanker Marco H
Publication year - 2022
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.16875
Subject(s) - medicine , urinary incontinence , psychological intervention , randomized controlled trial , physical therapy , quality of life (healthcare) , guideline , population , nursing , urology , environmental health , pathology
Objective To assess the long‐term effectiveness of app‐based treatment for female stress, urgency or mixed urinary incontinence (UI) compared with care‐as‐usual in primary care. Design A pragmatic, randomised controlled, superiority trial. Setting Primary care in the Netherlands from 2015 to 2018, follow up at 12 months. Population Women with two or more UI episodes per week and access to mobile apps, wanting treatment. A total of 262 women were randomised equally to app or care‐as‐usual; 89 (68%) and 83 (63%) attended 1 year follow up. Interventions The standalone app included conservative management for UI with motivation aids (e.g. reminders). Care‐as‐usual was delivered according to the Dutch GP guideline for UI. Main outcome measures Effectiveness assessed by the change in symptom severity score (ICIQ‐UI‐SF) and the change in quality of life (ICIQ‐LUTSqol) with linear regression on an intention‐to‐treat basis. Results Clinically relevant improvement of UI severity for both app (−2.17 ± 2.81) and care‐as‐usual (−3.43 ± 3.6) groups, with a non‐significant mean difference of 0.903 (−0.66 to 1.871). Conclusion App‐based treatment is a viable alternative to care‐as‐usual for UI in primary care in terms of effectiveness after 1 year. Tweetable abstract App‐based treatment for female urinary incontinence is a viable alternative to care‐as‐usual after 12 months.