Malin Sjöström

ICIQ symptom and quality of life instruments measure clinically relevant improvements in women with stress urinary incontinence

To determine whether changes in questionnaire scores on symptoms and condition‐specific quality of life reflect clinically relevant improvements in women with stress urinary incontinence (SUI).

Internet-based treatment of stress urinary incontinence: a randomised controlled study with focus on pelvic floor muscle training

Stress urinary incontinence (SUI) affects 10‒35% of women, and it is sometimes very distressful. Pelvic floor exercises are the first line of treatment, but access barriers or embarrassment may prevent women from seeking help. There is a need for new, simple, and effective ways to deliver treatment. Management of SUI without face‐to‐face contact is possible, and Internet‐based treatment is a new, promising treatment alternative.

Internet-based treatment of stress urinary incontinence: 1- and 2-year results of a randomized controlled trial with a focus on pelvic floor muscle training

To evaluate the long‐term effects of two non‐face‐to‐face treatment programmes for stress urinary incontinence (SUI) based on pelvic floor muscle training (PFMT).

Stress urinary incontinence and quality of life: a reliability study of a condition-specific instrument in paper and web-based versions.

Quality of life is an important outcome measure in studies of urinary incontinence. Electronic collection of data has several advantages. We examined the reliability of the Swedish version of the highly recommended condition‐specific quality of life questionnaire International Consultation on Incontinence Modular Questionnaire‐Lower Urinary Tract Symptoms Quality of Life (ICIQ‐LUTSqol), in paper and web‐based formats in women with stress urinary incontinence.

Women’s Experiences of Internet-Based or Postal Treatment for Stress Urinary Incontinence:

Stress urinary incontinence is common and sometimes embarrassing. New, simple, and easily accessible treatments are needed. We telephone interviewed 21 women who participated in a randomized controlled study comparing two treatment programs based on instructions for pelvic floor muscle training. One program was Internet-based and included email support by a urotherapist; the other was sent by post. There was no face-to-face contact in either program. Our main aim was to explore the women’s experiences of the Internet-based treatment. Grounded theory analysis revealed three categories: hidden but present, at a distance but close, and by myself but not alone. These were incorporated in a core category: acknowledged but not exposed. The leakage was often a well-hidden secret, but the study treatments lowered the barrier for seeking care. In the Internet group, a supportive patient–provider relationship developed despite the lack of face-to-face contact. Internet-based treatment programs can increase access to care and empower women.

Cost-effectiveness of an Internet-based treatment program for stress urinary incontinence

To perform a deterministic cost‐utility analysis, from a 1‐year societal perspective, of two treatment programs for stress urinary incontinence (SUI) without face‐to‐face contact: one Internet‐based and one sent by post. The treatments were compared with each other and with no treatment.

Mobile app for treatment of stress urinary incontinence : a randomized controlled trial

To evaluate the effect of a mobile app treatment for stress urinary incontinence (SUI) in women.

Mobile App for Treatment of Stress Urinary Incontinence: A Cost-Effectiveness Analysis

Background Mobile apps can increase access to care, facilitate self-management, and improve adherence to treatment. Stress urinary incontinence (SUI) affects 10-35% of women and, currently, an app with instructions for pelvic floor muscle training (PFMT) is available as first-line treatment. A previous randomized controlled study demonstrated that the app benefitted symptom severity and quality of life (QoL); in this study we investigate the cost-effectiveness of the app. Objective The objective of this study was to evaluate the health economy of the app for treating SUI. Methods This deterministic cost-utility analysis, with a 1-year societal perspective, compared the app treatment with no treatment. Health economic data were collected alongside a randomized controlled trial performed in Sweden from March 2013 to October 2014. This study included 123 community-dwelling women participants of 18 years and above, with stress urinary incontinence ≥1 time per week. Participants were self-assessed with validated questionnaires and 2-day leakage diaries, and then randomized to 3 months of treatment (app group, n=62) or no treatment (controls, n=61). The app focused on pelvic floor muscle training, prescribed 3 times daily. We continuously registered treatment delivery costs. Data were collected on each participant’s training time, incontinence aids, and laundry at baseline and at a 3-month follow-up. We measured quality of life with the International Consultation on Incontinence Modular Questionnaire on Lower Urinary Tract Symptoms and Quality of Life, and calculated the quality-adjusted life years (QALYs) gained. Data from the 3-month follow-up were extrapolated to 1 year for the calculations. Our main outcome was the incremental cost-effectiveness ratios compared between app and control groups. One-way and multiway sensitivity analyses were performed. Results The mean age of participants was 44.7 years (SD 9.4). Annual costs were €547.0 for the app group and €482.4 for the control group. Annual gains in quality-adjusted life years for app and control groups were 0.0101 and 0.0016, respectively. Compared with controls, the extra cost per quality-adjusted life year for the app group ranged from −€2425.7 to €14,870.6, which indicated greater gains in quality-adjusted life years at similar or slightly higher cost. Conclusions The app for treating stress urinary incontinence is a new, cost-effective, first-line treatment with potential for increasing access to care in a sustainable way for this patient group.

Non-face-to-face treatment of stress urinary incontinence : predictors of success after 1 year

Non-face-to-face treatment of stress urinary incontinence : predictors of success after 1 year