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Challenges in e-Health: The effect of digitalisation of frequency voiding charts on compliance in paediatric
Liesbeth L de Wall1, Elisabeth Am Kragt1, Eline Hm Van De Wetering1
1Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands.
Insights
Digital and paper voiding charts showed similar completion rates in a study comparing adherence. While digital charts were preferred for engagement, neither method significantly improved patient compliance with voiding symptom tracking.
Area of Science:
- Urology
- Pediatrics
- Health Informatics
Background:
- Frequency voiding charts are crucial for assessing voiding and drinking behaviors in patients with urinary symptoms.
- High non-compliance rates are a known challenge with traditional paper-based charts.
- Digital applications offer potential for improved adherence, but research is limited.
Purpose of the Study:
- To compare the quality and quantity of digital versus paper frequency voiding charts in children.
- To assess adherence and user experience with digital and paper charting methods.
Main Methods:
- A multi-center, parallel randomized controlled trial was conducted.
- Participants used either a 48-hour digital or paper frequency voiding chart.
- Completion rates were scored, and secondary outcomes included user-friendliness and attractiveness.
Main Results:
- No significant difference was found in the completion rates of digital (35%) versus paper (50%) charts (p=0.12).
- Participants found the digital application more appealing, educative, and inviting than paper charts (p<0.05).
Conclusions:
- This underpowered study found no significant difference in chart completion between digital and paper methods.
- E-health implementation did not demonstrably improve compliance in this context.
- Personal preference may be the most effective approach for chart utilization in clinical practice.
Objective:
Frequency voiding charts are commonly used to gain better insight into the voiding and drinking behaviours of patients with voiding symptoms. Non-compliance when filling out a chart is known to be high. The use of a digital application might increase adherence, but little research has been conducted on this topic. The aim of this study is to compare the quality (number of correctly filled out charts) and quantity (number of complete charts) of digital versus paper frequency voiding charts among children and their parents.
Methods:
A multi-centre parallel randomised controlled trial was conducted. Participants were assigned either a 48-h digital frequency voiding chart or a 48-h paper frequency voiding chart. Completion rates were scored based on a predefined scoring method and transcribed into a percentage. Secondary objectives included user friendliness, feasibility, degree of the child's participation, and attractiveness. Trail registry data: NTR NL9383.
Results:
Ninety-seven patients were randomised to either a digital (N = 53) or paper (N = 44) frequency voiding chart. No significant difference in complete and accurately filled out frequency voiding charts was seen between the groups, with 35% (N = 18) for digital and 50% (N = 22) for paper, p = 0.12. Subjects considered the digital application more appealing, more educative, and more inviting compared to the paper chart (p < 0.05).
Conclusions:
In this underpowered study, no significant difference appeared between the groups in the number of complete and accurately filled out frequency voiding charts. Implementation of e-health did not seem to improve compliance. In daily practice, personal preference might offer the best solution.
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