Digital Care Program for Urinary Incontinence in Females: A Large-Scale, Prospective, Cohort Study

• Published in: Healthcare (Basel) Vol. 12; no. 2; p. 141
• Main Authors: Janela, Dora, Areias, Anabela C, Molinos, Maria, Moulder, Robert G, Magalhães, Ivo, Bento, Virgílio, Cardeano, Marta, Yanamadala, Vijay, Correia, Fernando Dias, Atherton, Jennesa, Costa, Fabíola
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.01.2024
• Subjects: Analysis; Biofeedback; Biofeedback training; Care and treatment; Clinical practice guidelines; Cohort analysis; Diagnosis; digital therapeutics; Education; Evidence-based medicine; Intervention; Medical equipment; Medical examination; Mental health; Methods; Patients; pelvic floor dysfunction; pelvic floor muscle training; Pelvis; Physical therapists; Productivity; Questionnaires; Risk factors; Sensors; Stress; Telemedicine; telerehabilitation; Urinary incontinence; Vagina; Video teleconferencing; women’s health; United States; United States > US; biofeedback; digital therapeutics; pelvic floor dysfunction; women’s health; telerehabilitation; pelvic floor muscle training
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare12020141

Female urinary incontinence (UI) is highly prevalent in the US (>60%). Pelvic floor muscle training (PFMT) represents first-line care for UI; however, access and adherence challenges urge new care delivery models. This prospective cohort study investigates the feasibility and safety of a remote digital care program (DCP) combining education and PFMT with real-time biofeedback with an average duration of 10 weeks. The primary outcome was the change in the Urinary Impact Questionnaire-short form (UIQ-7) from baseline to program-end, calculated through latent growth curve analysis (LGCA). Secondary outcomes included the impact of pelvic conditions (PFIQ-7), depression (PHQ-9), anxiety (GAD-7), productivity impairment (WPAI), intention to seek additional healthcare, engagement, and satisfaction. Of the 326 participants who started the program, 264 (81.0%) completed the intervention. Significant improvement on UIQ-7 (8.8, 95%CI 4.7; 12.9, < 0.001) was observed, corresponding to a response rate of 57.3%, together with improvements in all other outcomes and high satisfaction (8.9/10, SD 1.8). This study shows the feasibility and safety of a completely remote DCP with biofeedback managed asynchronously by a physical therapist to reduce UI-related symptoms in a real-world setting. Together, these findings may advocate for the exploration of this care delivery option to escalate access to proper and timely UI care.