App-Based Treatment in Primary Care for Urinary Incontinence: A Pragmatic, Randomized Controlled Trial.

Area of Science:

• Urology
• Digital Health
• Primary Care

Background:

• Electronic application (app)-based treatments show promise for managing common conditions like urinary incontinence (UI).
• The comparative effectiveness of app-based UI treatment versus usual care in primary care settings remains unclear.

Purpose of the Study:

• To determine if app-based treatment for women with stress, urgency, or mixed UI is noninferior to usual care.
• To evaluate the efficacy of digital interventions for urinary incontinence in a primary care context.

Main Methods:

• A pragmatic, noninferiority randomized controlled trial (URinControl) involving adult women with UI.
• Comparison of a stand-alone app-based treatment (pelvic floor and bladder training) with usual care based on Dutch general practitioner guidelines.
• Primary outcome: change in symptom severity score from baseline to 4 months; secondary outcomes included quality of life and patient-perceived improvement.

Main Results:

• App-based treatment (-2.16 points) was noninferior to usual care (-2.56 points) in reducing symptom severity.
• Both app-based and usual care groups demonstrated improvements in outcome measures.
• No significant difference in effectiveness was found between the app-based treatment and usual care.

Conclusions:

• App-based treatment for women with UI is a viable and effective alternative to usual care in primary care.
• Digital health solutions for UI offer potential advantages in privacy, accessibility, and cost.
• App-based interventions can provide a valuable option for women seeking urinary incontinence management.