Programme no. 537-OP
Public Health
The eContinence project
Eva Samuelsson*1, Ina Asklund2, Emma Nyström3, Malin Sjöström4, Göran Umefjord5
1Department of public health and clinical medicine,Umeå university,Umeå,Sweden, 2Department of public health and clinical medicine,Umeå university,Umeå,Sweden, 3Department of public health and clinical medicine,Umeå university,Umeå,Sweden, 4Department of public health and clinical medicine,Umeå university,Umeå,Sweden, 5Department of public health and clinical medicine,Umeå university,Umeå,Sweden
* = Presenting author
Objectives: The overall aim of the project is to develop, evaluate and implement treatment programmes for urinary incontinence via Internet, Smartphone and PC tablet applications

Background: Urinary incontinence (UI) may severely affect quality of life and costs for society are high. Approximately one-fourth of women have UI. First-line treatments are lifestyle advice, pelvic floor muscle training (PFMT) for stress urinary incontinence (SUI) and bladder training for urgency urinary incontinence (UUI). Embarrassment may prevent those in need from seeking help; in addition, access to care varies and treatment is often not optimal. Of the Swedish population, 95% has access to the Internet, and ¾ use a smartphone. Our research group has developed treatment programmes for SUI in women via the internet, via a smartphone application and via a brochure. The efficacy of the Internet programme was evaluated in a randomized controlled trial (RCT) and a cost-utility analysis was done. The overall conclusion was that Internet-based treatment is a new, acceptable and affordable first-line treatment for SUI. The effect of treatment via the smartphone application ”tät” is evaluated in another trial. The implementation process and the development of programmes for UUI and mixed urinary incontinence (MUI) have started.

Results: Women treated via a smartphone application achieved significant and clinically relevant improvements regarding symptoms, QOL and urinary leakage, differences were significant between groups. An overview of ongoing studies within the eContinence project will be presented at the congress.

Material/Methods: Smartphone application study: RCT (Clinical trials NCT01848938), 123 women aged >18 yrs with SUI at least once a week were randomized to treatment via a smartphone application or to a postponed treatment group. Outcomes after three months treatment were incontinence episode frequency, incontinence severity, use of incontinence aids, condition-specific QOL and subjective improvement.

Implementation studies: Age, education level, place of residence, severity of incontinence and effect of treatment are studied during the implementation process.

Development and evaluation of a diagnostic and treatment programme for UUI and MUI in women: A new platform allows us to individually tailor actions depending on each individual’s preferences, symptoms, and needs. Different treatment programmes such as PFMT, bladder training and other behavioural therapies are included. The treatment effect will be studied in a RCT with the same validated outcomes as in our previous studies. Qualitative methods are also used.

Conclusion: Treatment via Internet/smartphone/pc tablet has the potential to increase access to care and to empower women with urinary incontinence to take an active role in their health care
Points for discussion: eHealth for urinary incontinence in clinical practice?