Predictors of response and adherence to enuresis alarm therapy-a confirmatory study

Amadeus Bergsten1, Jens Larsson2, Malin Borgström1,3

  • 1Dept of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Insights

This study found that while enuresis alarm therapy can be managed independently by families, nurse support improves adherence. Reassessing treatment after 4 weeks is recommended, as age and initial frequency predict success.

Area of Science:

  • Pediatric Urology
  • Behavioral Therapy
  • Digital Health

Background:

  • Bedwetting (enuresis) alarm therapy is a common treatment for nocturnal enuresis.
  • Exploring predictors of treatment response and adherence is crucial for optimizing outcomes.
  • Investigating the feasibility of independent family management of enuresis alarm therapy is warranted.

Purpose of the Study:

  • To identify predictors of response and adherence to enuresis alarm therapy.
  • To assess the efficacy of independent family management of enuresis alarm therapy.
  • To evaluate the role of nurse support in enuresis alarm therapy.

Main Methods:

  • A body-worn enuresis alarm linked to a smartphone app was utilized.
  • Subjects were recruited through pediatric nurses and independently by families.
  • Data from 385 nurse-supported and 1125 independent subjects were analyzed.

Main Results:

  • High dropout rates (79.9%) were observed before 8 weeks.
  • Among adherent subjects, 48.2% achieved a full or partial response.
  • Age was a predictor of non-response (p=0.019), and initial enuresis frequency decrease by 4 weeks was critical (p<0.001).
  • Adherence was higher with nurse support (p<0.001), but outcomes were similar for adherent subjects regardless of support (p=0.554).

Conclusions:

  • Daytime incontinence does not contraindicate enuresis alarm therapy.
  • Families can manage enuresis alarm treatment independently, though nurse support enhances adherence.
  • Treatment reassessment after 4 weeks is advised, and guidelines may need updating.
Abstract