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Treating incontinence in primary care:
A doctor versus mobile app trial

• App-based treatment in primary care for urinary incontinence: A pragmatic, randomized controlled trial

Leawood, KS, USA (March 9, 2021) — A mobile app designed to help women manage urinary incontinence was as effective as usual, in-person treatment of incontinence in primary care, according to new research from the Netherlands. The study included 262 women with frequent stress incontinence, overactive bladder or a mix of symptoms. Participants were randomly assigned to use a standalone mobile app called URinControl, which offered pelvic floor muscle and bladder training exercises. Those in a control group received standard care and were referred to their own primary care doctors who were broadly advised to follow the Dutch guidelines for primary care. After four months, women who used only the incontinence app and those who continued with standard care experienced similar results, with a decline in the severity of their symptoms, less frequent leakage and improved quality of life. Statistical analysis showed just over a one-half percentage point difference between the two groups‘ average decline in symptom severity. Therefore, the authors conclude that primary care physicians can offer care-as-usual and/or app-based treatment to women seeking help for urinary incontinence. Most importantly, the authors note, a mobile app will only be clinically relevant if it can demonstrate that it is either a less expensive option or offers an accessible and user-friendly alternative with significant long-term outcomes.

• App-Based Treatment in Primary Care for Urinary Incontinence: A Pragmatic, Randomized Controlled Trial
  Anne M. M. Loohuis, MD, et al
  University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
  https://www.annfammed.org/content/19/2/102

App-based and self-management tools have the potential to help individuals take control of their common urinary issues. In a corresponding editorial, Joel Heidelbaugh, MD, a clinical professor of family medicine and urology at the University of Michigan, discusses the significance of Loohuis et al’s mobile app study and Albarqouni et al’s review of self-management interventions, and highlights their value to both patients and primary care physicians. For patients, new e-health programs could help individuals manage their symptoms and improve their quality of life without medication, or they may experience additional benefits when combined with medication. For primary care physicians, apps and self-management tools might be a cost-effective and empowering strategy compared to usual care.

• Self-Directed Technology to Improve Urinary Symptoms
  Joel J. Heidelbaugh, MD
  University of Michigan Medical School, Ann Arbor, Michigan
  https://www.annfammed.org/content/19/2/100

American Academy of Family Physicians, 09.03.2021 (tB).