Effectiveness of Smart Continence Care for People With Profound Intellectual and Multiple Disabilities: Cluster...

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Disability Studies

Background:

• Scheduled continence care for individuals with profound intellectual and multiple disabilities (PIMD) in residential facilities can lead to leakage and unnecessary incontinence material (IM) changes.
• Smart continence care (SCC) technology aims to notify caregivers of IM changes, potentially improving personalized care and reducing negative impacts.

Purpose of the Study:

• To evaluate the effectiveness of SCC compared to regular continence care for individuals with PIMD.
• Primary outcome: reduction in weekly leakages. Secondary outcomes: reduction in weekly IM changes, time spent on continence care, quality of life, and caregiver burden.

Main Methods:

• A staggered-entry, open-label, cluster randomized trial involving 156 participants with PIMD across six residential care facilities in the Netherlands.
• The intervention group received SCC for 12 weeks, while the waiting-list group received regular continence care.
• Data were collected at baseline, 6, and 12 weeks, analyzed using generalized linear mixed models.

Main Results:

• SCC was ineffective in reducing weekly leakages; an unexpected decrease was observed in the waiting-list group.
• SCC significantly reduced the number of weekly incontinence material (IM) changes.
• No significant differences were found in time spent on continence care, quality of life, or caregiver physical burden.

Conclusions:

• Smart continence care (SCC) reduced incontinence material (IM) changes but not leakages in individuals with PIMD.
• Improvements in continence care were noted in both SCC and regular care groups, highlighting the impact of increased attention.
• Further research is needed to determine optimal settings for SCC implementation.