Internet-based treatment of stress urinary incontinence: a randomised controlled study with focus on pelvic floor muscle training
2013 (English)In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 112, no 3, 362-372 p.Article in journal (Refereed) Published
Objective less thanbrgreater than less thanbrgreater thanTo compare two treatment programmes for stress urinary incontinence (SUI) without face-to-face contact: one Internet-based and one sent by post. less thanbrgreater than less thanbrgreater thanPatients and Methods less thanbrgreater than less thanbrgreater thanRandomised, controlled trial conducted in Sweden 2009-2011. Computer-generated block-randomisation, allocation by independent administrator. No blinding. less thanbrgreater than less thanbrgreater thanThe study included 250 community-dwelling women aged 18-70 years, with SUI andgt;= 1 time/week. Consecutive online recruitment. less thanbrgreater than less thanbrgreater thanThe women had 3 months of either; (i) An Internet-based treatment programme (124 women), including e-mail support and cognitive behavioural therapy assignments or (ii) A treatment programme sent by post (126). Both programmes focused mainly on pelvic floor muscle training. less thanbrgreater than less thanbrgreater thanPrimary outcomes: symptom-score (International Consultation on Incontinence Questionnaire Short Form, ICIQ-UI SF) and condition-specific quality of life (ICIQ-Lower Urinary Tract Symptoms Quality of Life, ICIQ-LUTSQoL). Secondary outcomes: (i) Patient Global Impression of Improvement, (ii) Incontinence aids, (iii) Patient satisfaction, (iv) Health-specific QoL (EQ5D-Visual Analogue Scale), and (v) Incontinence episode frequency. Follow-up after 4 months via self-assessed postal questionnaires. less thanbrgreater than less thanbrgreater thanResults less thanbrgreater than less thanbrgreater thanIn all, 12% (30 women) were lost to follow-up. Intention-to-treat analysis showed highly significant improvements (P andlt; 0.001) with large effect sizes (andgt;0.8) with both interventions, but there were no significant differences between groups in primary outcomes. The mean (SD) changes in symptom-score were: Internet 3.4 (3.4), Postal 2.9 (3.1) (P = 0.27). The mean (SD) changes in condition-specific QoL were: Internet 4.8 (6.1), Postal 4.6 (6.7) (P = 0.52). less thanbrgreater than less thanbrgreater thanCompared with the postal-group, more participants in the Internet-group perceived they were much or very much improved (40.9% (43/105) vs 26.5% (30/113), P = 0.01), reported reduced usage of incontinence aids (59.5% (47/79) vs 41.4% (34/82), P = 0.02) and were satisfied with the treatment programme (84.8% (89/105) vs 62.9% (71/113), P andlt; 0.001). less thanbrgreater than less thanbrgreater thanHealth-specific QoL improved in the Internet-group (mean change 3.7 (10.9), P = 0.001), but not in the postal-group (1.9 (13.0), P = 0.13). less thanbrgreater than less thanbrgreater thanOverall, 69.8% (120/172) of participants reported complete lack of leakage or reduced number of leakage episodes by andgt;50%. less thanbrgreater than less thanbrgreater thanConclusions less thanbrgreater than less thanbrgreater thanConcerning primary outcomes, treatment effects were similar between groups whereas for secondary outcomes the Internet-based treatment was more effective. less thanbrgreater than less thanbrgreater thanInternet-based treatment for SUI is a new, promising treatment alternative.
Place, publisher, year, edition, pages
Wiley-Blackwell , 2013. Vol. 112, no 3, 362-372 p.
stress urinary incontinence, randomised controlled study, Internet, pelvic floor muscle training, self-management, cognitive behavioural therapy
IdentifiersURN: urn:nbn:se:liu:diva-95944DOI: 10.1111/j.1464-410X.2012.11713.xISI: 000321429800018OAI: oai:DiVA.org:liu-95944DiVA: diva2:641758
Funding Agencies|Swedish Research Council||2013-08-192013-08-122014-11-28