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.

Abstract

OBJECTIVE\nTo assess the long-term effectiveness of app-based treatment for female stress, urgency, or mixed urinary incontinence (UI) compared to care-as-usual in primary care.\n\n\nDESIGN\nA pragmatic, randomised controlled, superiority trial.\n\n\nSETTING\nPrimary care in the Netherlands from 2015 to 2018, follow-up at 12 months.\n\n\nPOPULATION\nWomen with ≥2 UI-episodes per week, access to mobile apps, wanting treatment. 262 women randomised equally to app or care-as-usual; 89 (68%) and 83 (63%) attended one year follow-up.\n\n\nINTERVENTIONS\nThe standalone app included conservative management for UI with motivation aids (e.g., reminders). Care-as-usual delivered according to the Dutch GP guideline for UI.\n\n\nMAIN OUTCOME MEASURES\nEffectiveness assessed by the change in symptom severity score (ICIQ-UI-SF) and the change in quality of life (ICIQ-LUTS-QoL) with linear regression on an intention-to-treat basis.\n\n\nRESULTS\nClinically relevant improvement of UI severity for both app (-2.17 ± 2.81) and care-as-usual (-3.43 ± 3.6), with a non-significant mean difference of 0.903 (-0.66 to 1.871).\n\n\nCONCLUSION\nApp-based treatment is a viable alternative to care-as-usual for UI in primary care in terms of effectiveness after one year.