ICS 2022: Long-Term Results Of App-Based Self-Management Of Urgency And Mixed Urinary Incontinence In Women

(UroToday.com) Delivering behavioral interventions, specifically pelvic floor muscle training (PFMT), via a mobile app has exploded over the past few years. The Tät®II,  a popular mobile app includes PFMT, bladder training, psycho-education, lifestyle advice, an exercise log, reminders, reinforcement messages, and tailored advice.  In a 15-week randomized controlled trial (RCT), this app was shown to be effective for the self-management of urgency urinary incontinence (UUI), and mixed urinary incontinence (MUI).

This study reports on long-term follow-up of a RCT of Tät®II mobile app in 123 women ≥18 years old (102/83% completers) with UUI or MUI, who reported ≥2 leakages per week. All participants, regardless of their original allocation to intervention or control, had received the intervention, a treatment app, at the long-term follow-up.  The primary outcome was a change in incontinence symptoms (International Consultation on Incontinence Questionnaire (ICIQ)−Urinary Incontinence Short Form (ICIQ-UI SF)), from baseline to follow-up. Other outcomes were urgency symptoms (ICIQ−Overactive Bladder Module (ICIQ-OAB)), quality of life (ICIQ−Lower Urinary Tract Symptoms Quality of Life Module (ICIQ-LUTSqol)), and improvement (Patient’s Global Impression of Improvement (PGI-I)). The Incontinence Catastrophizing (IC) Scale (0-21 points) was used to assess the participant’s tendency to catastrophize over their incontinence. It was adapted from the validated Pain Catastrophizing Scale (short version) and contains 7 items covering fear of leakage and urgency.

The ICIQ-UI SF mean score improved from 11.5 to 7.6, the ICIQ-OAB improved from 6.7 to 5.5, the ICIQ-LUTSqol improved from 38.0 to 30.9 and the IC score improved from 4.8 to 2.5. The difference between baseline and the long-term follow-up score was statistically significant for all outcomes. There were no significant differences in any scores between the short-term and long-term follow-up. The improvement at the short-term follow-up was sustained at the long-term follow-up for all outcomes.

Presented by: Towe Wadensten, Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

Written by: Diane Newman, DNP, CRNP, FAAN, BCB-PMD, Urologic Nurse Practitioner, Adjunct Professor of Urology in Surgery, Senior Research Investigator, Perelman School of Medicine, University of Pennsylvania during the International Continence Society Annual Meeting, September 7-10, 2022, Vienna, Austria.

References:

  1. Loohuis AMM, Van Der Worp H, Wessels NJ, Dekker JH, Slieker-Ten Hove MCP, Berger MY, et al. 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. BJOG. 2022 Aug;129(9):1474-1480.  doi: 10.1111/1471-0528.16875
  2. Wadensten T, Nystrom E, Franzen K, Lindam A, Wasteson E, Samuelsson E. A Mobile App for Self-management of Urgency and Mixed Urinary Incontinence in Women: Randomized Controlled Trial. J Med Internet Res. 2021;23(4):e19439.
  3. Wadensten T, Nyström E, Nord A, Lindam A, Sjöström M, Samuelsson E. App-based self-management of urgency and mixed urinary incontinence in women: One-year follow-up. Neurourol Urodyn. 2022  Apr;41(4):945-954. doi: 10.1002/nau.24898.