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.
Aim:
To look for predictors to response and adherence to the enuresis alarm while exploring the possibility of families managing therapy independently.
Methods:
We used a body-worn alarm linked to a smartphone app. Subjects with enuresis were recruited both via paediatric nurses and independently as families bought the alarm and downloaded the app on their own.
Results:
We recruited 385 nurse-supported and 1125 independent subjects. Many (79.9%) dropped out before 8 weeks, but among adherent subjects 48.2% had a full or partial response. Age was a predictor of non-response (p = 0.019). Daytime incontinence did not influence response. If enuresis frequency did not decrease during the first 4 weeks of therapy the chance of response was very small (p < 0.001). Adherence was higher among subjects supported by a nurse (p < 0.001), but for adherent subjects the outcome was similar regardless of nurse support (p = 0.554).
Conclusions:
Daytime incontinence is no contraindication to enuresis alarm therapy. Treatment can be managed independently by the families, but adherence is enhanced by nurse support. Alarm treatment should be reassessed after 4 weeks. Enuresis alarm treatment guidelines need to be updated.
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