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. 2018 Sep;29(9):1325-1333.
doi: 10.1007/s00192-017-3514-1. Epub 2017 Dec 8.

Treatment of stress urinary incontinence with a mobile app: factors associated with success

Emma Nyström  1 , Ina Asklund  2 , Malin Sjöström  2 , Hans Stenlund  3 , Eva Samuelsson  3
Affiliations

Treatment of stress urinary incontinence with a mobile app: factors associated with success

Emma Nyström et al. Int Urogynecol J. 2018 Sep.

Abstract

Introduction and hypothesis: Stress urinary incontinence is common among women. First-line treatment includes pelvic floor muscle training (PFMT) and lifestyle advice, which can be provided via a mobile app. The efficacy of app-based treatment has been demonstrated in a randomized controlled trial (RCT). In this study, we aimed to analyze factors associated with successful treatment.

Methods: Secondary analysis of data from the RCT. At baseline and 3-month follow-up, participants (n = 61) answered questions about symptoms, quality of life, background, and PFMT. Success was defined as rating the condition as much or very much better according to the validated Patient Global Impression of Improvement questionnaire. Factors possibly associated with success were analyzed with univariate logistic regression; if p < 0.20, the factor was entered into a multivariate model that was adjusted for age. Variables were then removed stepwise.

Results: At follow-up, 34 out of 61 (56%) of participants stated that their condition was much or very much better. Three factors were significantly associated with success: higher expectations for treatment (odds ratio [OR] 11.38, 95% confidence interval [CI] 2.02-64.19), weight control (OR 0.44 per kg gained, 95% CI 0.25-0.79), and self-rated improvement of pelvic floor muscle strength (OR 35.54, 95% CI 4.96-254.61). Together, these factors accounted for 61.4% (Nagelkerke R2) of the variability in success.

Conclusion: These results indicate that app-based treatment effects are better in women who are interested in and have high expectations of such treatment. Also, the findings underline the importance of strengthening the pelvic floor muscles and offering lifestyle advice.

Keywords: Mobile applications; Pelvic floor muscle training; Self-management; Stress urinary incontinence.

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Conflict of interest statement

Conflicts of interest

The authors declare that they have no conflicts of interest. The application Tät® was developed by Eva Samuelsson, Göran Umefjord, and Malin Sjöström in collaboration with ICT Service and System development at Umeå University. Copyright 2010–2017 Tät.nu, at Umeå university. All rights reserved. The name Tät (mobile application) and the logo Tät.nu are registered as Trademarks by The Swedish Patent and Registration office for E Samuelsson at Umeå University. The application is CE-marked as a medical device class I, according to Swedish regulation LVFS 2003:11. Available for free in Swedish and English at the Apple App Store and Google Play. None of the researchers has any financial interests in the product.

Figures

Fig. 1
Fig. 1
Data collected at inclusion and follow-up and features of the mobile app for treatment of stress urinary incontinence in women. ICIQ-UI SF International Consultation on Incontinence Modular Questionnaire—Urinary Incontinence Short Form, ICIQ-LUTSqol International Consultation on Incontinence Modular Questionnaire—Lower Urinary Tract Symptoms Quality of Life, IEF incontinence episode frequency, PFMT pelvic floor muscle training, SUI stress urinary incontinence, PGI-I Patient Global Impression on Improvement
Fig. 2
Fig. 2
Patient Global Impression of Improvement (PGI-I) at 3-month follow-up and definition of successful outcome after treatment for stress urinary incontinence
See this image and copyright information in PMC

Comment in

References

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