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Mehta S, Carmain M, Dalal S, Lundsberg L, St Martin B, Harmanli O. Effect of Educational Video on Patient Adherence and Completeness of Voiding Diaries: A Randomized Trial. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024; 30:413-419. [PMID: 37737826 DOI: 10.1097/spv.0000000000001409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
IMPORTANCE Voiding diaries are clinically useful tools for elucidating the etiology of lower urinary tract symptoms. The utility of voiding diaries is challenged by low return rate and incomplete or inaccurate data entry. OBJECTIVE The objective was to determine the effect of the use of an educational video on patient adherence, completeness of intake and voiding diaries, and patient satisfaction. STUDY DESIGN In this trial, patients who were asked to complete an intake and voiding diary in a urogynecology clinic were randomized to receive standard education or enhanced education with an instructional video on how to complete the diary. Patients returned the diaries at their follow-up visits in the clinic. The primary outcome was the return rate of the diaries. Upon follow-up, patients filled out a survey reporting their satisfaction with instructions received. Diaries were graded by 3 blinded experts. RESULTS Eighty-five patients were enrolled, 42 in the standardized instructions arm and 43 in the video arm. A total of 26 patients (30.6%) filled out and returned an intake and voiding diary. Between groups, there was no difference in the rate of return of the diaries ( P = 0.59) or in completeness of the returned voiding diaries ( P = 0.60). The educational video did not change satisfaction between the groups; patients reported identical satisfaction between groups. CONCLUSIONS The addition of an instructional video on how to complete an intake and voiding diary did not increase patients' rate of return, completeness of diaries, or satisfaction with instructions provided to complete the diary.
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Affiliation(s)
- Shailja Mehta
- From the Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT
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Meyer I, Iriondo-Perez J, Dyer KY, Sung V, Ackenbom MF, Florian-Rodriguez M, Kim E, Mazloomdoost D, Carper B, Gantz MG. Correlation Between Mobile-Application Electronic Bowel Diary and Validated Questionnaires in Women with Fecal Incontinence. Int Urogynecol J 2024; 35:545-551. [PMID: 38206340 PMCID: PMC11023758 DOI: 10.1007/s00192-023-05711-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/28/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Despite growing interest in a mobile-app bowel diary to assess fecal incontinence (FI) symptoms, data are limited regarding the correlation between mobile-app diary and questionnaire-based outcomes. The primary aim is to determine whether percentage reduction in FI episodes (FIEs)/week recorded on a mobile-app diary correlates with changes in scores of validated FI-symptom measures from baseline to 12 weeks in women with FI undergoing percutaneous tibial nerve stimulation (PTNS) versus sham. METHODS This is a planned secondary analysis of a multicenter randomized trial in which women with FI underwent PTNS or sham. FIEs were collected using a mobile-app diary at baseline and after 12 weekly sessions. FI-symptom-validated measures included St. Mark's, Accidental Bowel Leakage Evaluation, FI Severity Index (FISI), Colorectal Anal Distress Inventory, Colorectal Anal Impact Questionnaire, FI Quality of Life, Patient Global Impression of Improvement (PGI-I), and Patient Global Symptom Control (PGSC) rating. Spearman's correlation coefficient (ρ) was computed between %-reduction in FIEs/week and change in questionnaire scores from baseline to 12 weeks. Significance was set at 0.005 to account for multiple comparisons. RESULTS Baseline characteristics of 163 women (109 PTNS, 54 sham) include mean age 63.4±11.6, 81% white, body mass index 29.4±6.6 kg/m2, 4% previous FI surgeries, 6.6±5.5 FIEs/week, and St. Mark's score 17.4±2.6. A significant correlation was demonstrated between %-reduction in FIEs/week and all questionnaires (p<0.005). A moderate-strength correlation (|ρ|>0.4) was observed for St. Mark's (ρ=0.48), FISI (ρ=0.46), PGI-I (ρ=0.51), and PGSC (ρ=-0.43). CONCLUSIONS In women with FI randomized to PTNS versus sham, a moderate correlation was noted between FIEs measured via mobile-app diary and FI-symptom-validated questionnaire scores.
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Affiliation(s)
- Isuzu Meyer
- Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
| | | | | | - Vivian Sung
- Alpert Medical School of Brown University, University/Women & Infants Hospital, Providence, RI, USA
| | - Mary F Ackenbom
- Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Edward Kim
- Department of Obstetrics & Gynecology, Division of Urogynecology, University of Pennsylvania, Philadelphia, PA, USA
| | - Donna Mazloomdoost
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | | | - Marie G Gantz
- RTI International, Research for the NICHD Pelvic Floor Disorders Network, Triangle Park, NC, USA
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Bladt L, Kashtiara A, Platteau W, De Wachter S, De Win G. First-Year Experience of Managing Urology Patients With Home Uroflowmetry: Descriptive Retrospective Analysis. JMIR Form Res 2023; 7:e51019. [PMID: 37847531 PMCID: PMC10618888 DOI: 10.2196/51019] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Lower urinary tract symptoms affect a large number of people of all ages and sexes. The clinical assessment typically involves a bladder diary and uroflowmetry test. Conventional paper-based diaries are affected by low patient compliance, whereas in-clinic uroflowmetry measurement face challenges such as patient stress and inconvenience factors. Home uroflowmetry and automated bladder diaries are believed to overcome these limitations. OBJECTIVE In this study, we present our first-year experience of managing urological patients using Minze homeflow, which combines home uroflowmetry and automated bladder diaries. Our objective was 2-fold: first, to provide a description of the reasons for using homeflow and second, to compare the data obtained from homeflow with the data obtained from in-clinic uroflowmetry (hospiflow). METHODS A descriptive retrospective analysis was conducted using Minze homeflow between July 2019 and July 2020 at a tertiary university hospital. The device comprises a Bluetooth-connected gravimetric uroflowmeter, a patient smartphone app, and a cloud-based clinician portal. Descriptive statistics, Bland-Altman plots, the McNemar test, and the Wilcoxon signed rank test were used for data analysis. RESULTS The device was offered to 166 patients, including 91 pediatric and 75 adult patients. In total, 3214 homeflows and 129 hospiflows were recorded. Homeflow proved valuable for diagnosis, particularly in cases where hospiflow was unreliable or unsuccessful, especially in young children. It confirmed or excluded abnormal hospiflow results and provided comprehensive data with multiple measurements taken at various bladder volumes, urge levels, and times of the day. As a result, we found that approximately one-fourth of the patients with abnormal flow curves in the clinic had normal bell-shaped flow curves at home. Furthermore, homeflow offers the advantage of providing an individual's plot of maximum flow rate (Q-max) versus voided volume as well as an average or median result. Our findings revealed that a considerable percentage of patients (22/76, 29% for pediatric patients and 24/50, 48% for adult patients) had a Q-max measurement from hospiflow falling outside the range of homeflow measurements. This discrepancy may be attributed to the unnatural nature of the hospiflow test, resulting in nonrepresentative uroflow curves and an underestimation of Q-max, as confirmed by the Bland-Altman plot analysis. The mean difference for Q-max was -3.1 mL/s (with an upper limit of agreement of 13 mL/s and a lower limit of agreement of -19.2 mL/s), which was statistically significant (Wilcoxon signed rank test: V=2019.5; P<.001). Given its enhanced reliability, homeflow serves as a valuable tool not only for diagnosis but also for follow-up, allowing for the evaluation of treatment effectiveness and home monitoring of postoperative and recurrent interventions. CONCLUSIONS Our first-year experience with Minze homeflow demonstrated its feasibility and usefulness in the diagnosis and follow-up of various patient categories. Homeflow provided more reliable and comprehensive voiding data compared with hospiflow.
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Affiliation(s)
- Lola Bladt
- Product Development, Faculty of Design Sciences, University of Antwerp, Antwerp, Belgium
| | - Ardavan Kashtiara
- Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Wouter Platteau
- Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Stefan De Wachter
- Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Urology, University Hospital Antwerp, Antwerp, Belgium
| | - Gunter De Win
- Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Urology, University Hospital Antwerp, Antwerp, Belgium
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Baude M, Guihard M, Gault-Colas C, Bénichou L, Coste A, Méningaud JP, Schmitz D, Natella PA, Audureau E, Gracies JM. Guided Self-rehabilitation Contract vs conventional therapy in chronic peripheral facial paresis: VISAGE, a multicenter randomized controlled trial. BMC Neurol 2023; 23:148. [PMID: 37038105 PMCID: PMC10084642 DOI: 10.1186/s12883-023-03096-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/27/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND One year after persistent peripheral facial paresis (PFP), prescriptions of conventional rehabilitation are often downgraded into maintenance rehabilitation or discontinued, the patient entering what is seen as a chronic stage. This therapeutic choice is not consistent with current knowledge about behavior-induced plasticity, which is available all life long and may allow intense sensorimotor rehabilitation to remain effective. This prospective, randomized, multicenter single-blind study in subjects with chronic unilateral PFP evaluates changes in facial motor function with a Guided Self-rehabilitation Contract (GSC) vs. conventional therapy alone, carried out for six months. METHODS Eighty-two adult subjects with chronic unilateral PFP (> 1 year since facial nerve injury) will be included in four tertiary, maxillofacial surgery (2), otolaryngology (1) and rehabilitation (1) centers to be randomized into two rehabilitation groups. In the experimental group, the PM&R specialist will implement the GSC method, which for PFP involves intensive series of motor strengthening performed daily on three facial key muscle groups, i.e. Frontalis, Orbicularis oculi and Zygomatici. The GSC strategy involves: i) prescription of a daily self-rehabilitation program, ii) teaching of the techniques involved in the program, iii) encouragement and guidance of the patient over time, in particular by requesting a quantified diary of the work achieved to be returned by the patient at each visit. In the control group, participants will benefit from community-based conventional therapy only, according to their physician's prescription. The primary outcome measure is the composite score of Sunnybrook Facial Grading System. Secondary outcome measures include clinical and biomechanical facial motor function quantifications (Créteil Scale and 3D facial motion analysis through the Cara system), quality of life (Facial Clinimetric Evaluation and Short-Form 12), aesthetic considerations (FACE-Q scale) and mood representations (Hospital Anxiety and Depression scale). Participants will be evaluated every three months by a blinded investigator, in addition to four phone calls (D30/D60/D120/D150) to monitor compliance and tolerance to treatment. DISCUSSION This study will increase the level of knowledge on the effects of intense facial motor streng- Facial paralysisthening prescribed through a GSC in patients with chronic peripheral facial paresis. TRIAL REGISTRATION ClinicalTrials.gov, NCT04074018 . Registered 29 August 2019. PROTOCOL VERSION Version N°4.0-04/02/2021.
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Affiliation(s)
- Marjolaine Baude
- BIOTN Research Unit 7377, Université Paris-Est Créteil (UPEC), 94000, Créteil, France.
- Service de Rééducation Neurolocomotrice, AP-HP, Hôpitaux Universitaires Henri Mondor, 1 Rue Gustave Eiffel, 94000, Créteil, France.
| | - Marina Guihard
- BIOTN Research Unit 7377, Université Paris-Est Créteil (UPEC), 94000, Créteil, France
| | - Caroline Gault-Colas
- Service de Rééducation Neurolocomotrice, AP-HP, Hôpitaux Universitaires Henri Mondor, 1 Rue Gustave Eiffel, 94000, Créteil, France
| | - Ludovic Bénichou
- Hôpital Paris Saint-Joseph, Service de Chirurgie Maxillo-Faciale Stomatologie, 75015, Paris, France
| | - André Coste
- Centre Hospitalier Intercommunal Créteil, Service d'ORL, Stomatologie Et Chirurgie Cervico-Faciale, 94000, Créteil, France
| | - Jean-Paul Méningaud
- AP-HP, Service de Chirurgie Plastique, Reconstructrice, Esthétique Et Maxillo-Faciale, Hôpitaux Universitaires Henri Mondor, 94000, Créteil, France
| | - David Schmitz
- AP-HP, Unité de Recherche Clinique, Hôpitaux Universitaires Henri Mondor, 94000, Créteil, France
| | - Pierre-André Natella
- AP-HP, Unité de Recherche Clinique, Hôpitaux Universitaires Henri Mondor, 94000, Créteil, France
| | - Etienne Audureau
- AP-HP, Unité de Recherche Clinique, Hôpitaux Universitaires Henri Mondor, 94000, Créteil, France
- AP-HP, Service de Santé Publique, Hôpitaux Universitaires Henri Mondor, 94000, Créteil, France
- DHU A-TVB, IRMB- EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit), Université Paris Est-Créteil, 94000, Créteil, France
| | - Jean-Michel Gracies
- BIOTN Research Unit 7377, Université Paris-Est Créteil (UPEC), 94000, Créteil, France
- Service de Rééducation Neurolocomotrice, AP-HP, Hôpitaux Universitaires Henri Mondor, 1 Rue Gustave Eiffel, 94000, Créteil, France
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LUKACZ ES, FALKE C, GEYNISMAN-TAN J, WYMAN JF, MUELLER ER, MARKLAND AD, RICKEY L, LOWDER JL, RUDSER K, LOW LKANE, NEWMAN DK. Healthy bladder storage and emptying functions in community-dwelling women measured by a 2-day bladder health diary. Neurourol Urodyn 2023; 42:725-735. [PMID: 36891924 PMCID: PMC10101892 DOI: 10.1002/nau.25169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/08/2023] [Accepted: 02/25/2023] [Indexed: 03/10/2023]
Abstract
INTRODUCTION The prevalence of healthy bladder storage and emptying function in community-dwelling women is not well established. METHODS A planned secondary analysis of a US cross-sectional study designed to validate a bladder health instrument was conducted in women aged ≥18 years. A subset was invited to complete the novel 2-day bladder health diary capturing bladder storage and emptying experiences. Overall healthy bladder function was defined as ≤8 waking/daytime voids and ≤1 void during sleeping/nighttime; along with the absence of leakage, urgency, emptying difficulties (initiation, flow, efficacy, relief of urge sensation) and pain. Descriptive statistics of healthy bladder functions and regression models of factors associated with healthy function are reported. RESULTS Of the 383 invited, 237 (62%) eligible women returned complete dairies. Of these, 12% (29/237) met criteria for overall healthy bladder function. Most (96%) denied pain, 74% had healthy daytime and 83% had healthy nighttime voiding frequency, 64% were continent, 36% reported healthy emptying and 30% denied any urgency episodes. Middle income (odds ratio [OR]:95% confidence interval [CI] = 11.4:1.9-67.4 for $75k-$99 999 vs. $25 000-$49 999), Graduate education (4.8:1.4-17) and previously seeking treatment for bladder problems (OR:95%CI = 0.1; 0-0.9) were associated with overall healthy function. CONCLUSION The prevalence of overall healthy bladder function was very low based on our strict definition of health as measured on a 2-day diary. However, most women had healthy voiding frequency and denied pain or urinary leakage. Postvoid dribbling and urgency most commonly contributed to an overall unhealthy bladder. Further investigation is needed to determine whether these diary derived measures are meaningful for patient-oriented bladder health research.
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Affiliation(s)
- Emily S. LUKACZ
- University of California San Diego, Department of Obstetrics, Gynecology & Reproductive Sciences, La Jolla, CA
| | - Chloe FALKE
- Division of Biostatistics, University of Minnesota, Minneapolis, MN
| | - Julia GEYNISMAN-TAN
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL
| | - Jean F. WYMAN
- School of Nursing, University of Minnesota, Minneapolis, MN
| | - Elizabeth R MUELLER
- Departments of Urology & Obstetrics/Gynecology, Loyola University Medical Center, Loyola University, Chicago, IL
| | - Alayne D. MARKLAND
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, AL and the Birmingham/Atlanta Geriatric Research, Education, and Clinical Center
| | - Leslie RICKEY
- Departments of Urology & Obstetrics/Gynecology, Yale University School of Medicine, New Haven, CT
| | - Jerry L. LOWDER
- Department of Obstetrics and Gynecology, Washington University in St Louis School of Medicine, St Louis, MO
| | - Kyle RUDSER
- Division of Biostatistics, University of Minnesota, Minneapolis, MN
| | - Lisa KANE LOW
- School of Nursing, University of Michigan, Ann Arbor, MI
| | - Diane K. NEWMAN
- Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Mehta S, Geng B, Xu X, Harmanli O. Current state of bladder diary: a survey and review of the literature. Int Urogynecol J 2023; 34:809-823. [PMID: 36322174 DOI: 10.1007/s00192-022-05398-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objectives of this study are (1) to assess practice patterns among urogynecology/female pelvic medicine and reconstructive surgery (FPMRS) providers regarding the use of bladder diaries (BD) and (2) to review the literature regarding BD. METHODS For the first objective, a survey was emailed to United States-based urogynecology providers in 2019 querying frequency of use of bladder diaries (FBD), indications, problems, patient education methods, and perception of utility. Chi-square tests and multiple logistic regression were performed. For the second objective, we reviewed literature published in English by searching the terms "voiding," "bladder," or "incontinence," in combination with "diary," "log," or "questionnaire." RESULTS A total of 371 of 851 (43.5%) contacted providers responded. Nearly 80% were attending physicians, 75.5% of whom completed the FPMRS fellowship; 20.8% of all respondents and nearly 25% of fellowship-trained attendings reported FBD <20% in the last year. FPMRS providers were more likely to report FBD >80%. A total of 97.5% of respondents cited difficulty in using BD. Most (71.6%) taught patients to use BD themselves or shared responsibility with a nonphysician staff member (53.4%). BD is a validated and valuable instrument; however, there are obstacles to its use. Despite recent innovations including electronic and automated BD, there is a paucity of data regarding the provider-viewed challenges in implementing BD. CONCLUSIONS The literature supports the use of BD; however, many survey respondents, including fellowship-trained attendings, never or rarely use BD. Most respondents reported difficulty in using BD. More research is needed to improve the ease, accuracy, and widespread adaptation of BD use in clinical practice.
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Affiliation(s)
- Shailja Mehta
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 310 Cedar Street, FMB 329, New Haven, CT, 06510, USA
| | - Bertie Geng
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 310 Cedar Street, FMB 329, New Haven, CT, 06510, USA
| | - Xiao Xu
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 310 Cedar Street, FMB 329, New Haven, CT, 06510, USA
| | - Oz Harmanli
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 310 Cedar Street, FMB 329, New Haven, CT, 06510, USA.
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de Wall LL, Kragt EAM, Van De Wetering EHM, Cobussen-Boekhorst JGL, Mantel-van Stel J, Kortmann BBM, Feitz WF, Bootsma-Robroeks CMHHT. Challenges in e-Health: The effect of digitalisation of frequency voiding charts on compliance in paediatric patients. Randomised controlled trial comparing digital and versus paper frequency voiding charts. Digit Health 2023; 9:20552076231207577. [PMID: 37954691 PMCID: PMC10634267 DOI: 10.1177/20552076231207577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 09/28/2023] [Indexed: 11/14/2023] Open
Abstract
Objective Frequency voiding charts are commonly used to gain better insight into the voiding and drinking behaviours of patients with voiding symptoms. Non-compliance when filling out a chart is known to be high. The use of a digital application might increase adherence, but little research has been conducted on this topic. The aim of this study is to compare the quality (number of correctly filled out charts) and quantity (number of complete charts) of digital versus paper frequency voiding charts among children and their parents. Methods A multi-centre parallel randomised controlled trial was conducted. Participants were assigned either a 48-h digital frequency voiding chart or a 48-h paper frequency voiding chart. Completion rates were scored based on a predefined scoring method and transcribed into a percentage. Secondary objectives included user friendliness, feasibility, degree of the child's participation, and attractiveness. Trail registry data: NTR NL9383. Results Ninety-seven patients were randomised to either a digital (N = 53) or paper (N = 44) frequency voiding chart. No significant difference in complete and accurately filled out frequency voiding charts was seen between the groups, with 35% (N = 18) for digital and 50% (N = 22) for paper, p = 0.12. Subjects considered the digital application more appealing, more educative, and more inviting compared to the paper chart (p < 0.05). Conclusions In this underpowered study, no significant difference appeared between the groups in the number of complete and accurately filled out frequency voiding charts. Implementation of e-health did not seem to improve compliance. In daily practice, personal preference might offer the best solution.
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Affiliation(s)
- Liesbeth L de Wall
- Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Elisabeth AM Kragt
- Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Eline HM Van De Wetering
- Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Johanna GL Cobussen-Boekhorst
- Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Joyce Mantel-van Stel
- Department of Paediatric Urology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Barbara BM Kortmann
- Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Wout F Feitz
- Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Charlotte MHHT Bootsma-Robroeks
- Department of Paediatrics, Paediatric Nephrology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Zhang S, Fang S, Wang W, Li Y, Zhang X, Meng X, Su J, Chang A, Sun J. A systematic review of the application of a diary for people with dementia: how to maximise the effect of diary use? Psychogeriatrics 2022; 22:269-280. [PMID: 34931410 DOI: 10.1111/psyg.12800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/09/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022]
Abstract
Diaries have been widely used among people with dementia as a data collection tool and memory aid. An understanding of their usage is conducive to the subsequent development of intervention measures, but comprehensive evidence is still lacking. This review synthesises the existing literature to obtain an in-depth understanding of the positive and negative effects of diary usage among people with dementia and the influencing factors. The data were collected from eight databases from the inception of each database to November 2020. A thematic synthesis method was used to sort and summarise the included studies. Ten studies were chosen for the review. The following three analytical themes were identified: (i) positive changes; (ii) factors affecting the record; and (iii) negative feelings. Diaries can cause positive changes in people with dementia, but the specific patterns of stimulation and changes over time remain to be explored. Furthermore, researchers should encourage patients and their families to have a correct understanding of the diary, improve their motivation and social support, fully use the positive effects of the diary, and reduce the occurrence of negative effects. Medical staff should help caregivers improve their awareness of the usefulness and ease of the diary and encourage them to provide support and companionship to people with dementia while exhibiting a positive attitude.
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Affiliation(s)
- Shuang Zhang
- School of Nursing, Jilin University, Jilin, China
| | - Shuyan Fang
- School of Nursing, Jilin University, Jilin, China
| | - Wenxia Wang
- School of Nursing, Jilin University, Jilin, China
| | - Yijing Li
- School of Nursing, Jilin University, Jilin, China
| | - Xu Zhang
- School of Nursing, Jilin University, Jilin, China
| | | | - Jianping Su
- School of Nursing, Jilin University, Jilin, China.,School of Nursing, Xinjiang Medical University, Xinjiang, China
| | - An Chang
- School of Nursing, Jilin University, Jilin, China
| | - Jiao Sun
- School of Nursing, Jilin University, Jilin, China
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Gomes CM, Moromizato JKM, Ribeiro LS. Mobile health may improve evaluation of lower urinary tract symptoms. Int Braz J Urol 2021. [PMID: 34469671 PMCID: PMC8486450 DOI: 10.1590/s1677-5538.ibju.2021.0211.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Na HS, Kim KH. Development of urination recognition technology based on Support Vector Machine using a smart band. J Exerc Rehabil 2021; 17:287-292. [PMID: 34527641 PMCID: PMC8413907 DOI: 10.12965/jer.2142474.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/04/2021] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to explore the feasibility of a urination management system by developing a smart band-based algorithm that recognizes the urination interval of women. We designed a device that recognizes the time and interval of urination based on the patient’s specific posture and posture changes. The technology used for recognition applied the Radial Basis Function kernel-based Support Vector Machine, a teaching and learning method that facilitates multidimensional analysis by simultaneously judging the characteristics of complex learning data. In order to evaluate the performance of the proposed recognition technique, we compared actual urination and device-sensed urination. An experiment was performed to evaluate the performance of the recognition technology proposed in this study. The efficacy of smart band monitoring urination was evaluated in 10 female patients without urination problems. The entire experiment was performed over a total of 3 days. The average age of the participants was 28.73 years (26–34 years), and there were no signs of dysuria. The final accuracy of the algorithm was calculated based on clinical guidelines for urologists. The experiment showed a high average accuracy of 91.0%, proving the robustness of the proposed algorithm. This urination behavior recognition technique shows high accuracy and can be applied in clinical settings to characterize urination patterns in female patients. As wearable devices develop and become more common, algorithms that detect specific sequential body movement patterns that reflect specific physiological behaviors could become a new methodology to study human physiological behavior.
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Affiliation(s)
- Hyun Seok Na
- Department of Urology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Khae Hawn Kim
- Department of Urology, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea
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11
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Gomes CM, Moromizato JKM, Ribeiro LS. Mobile health may improve evaluation of lower urinary tract symptoms. Int Braz J Urol 2021; 47:1195-1197. [PMID: 34469665 PMCID: PMC8486462 DOI: 10.1590/s1677-5538.ibju.2021.06.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 08/10/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Cristiano M Gomes
- Divisão de Urologia do Departamento de Cirurgia da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Julyana K M Moromizato
- Divisão de Urologia do Departamento de Cirurgia da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Lucia S Ribeiro
- Divisão de Urologia do Departamento de Cirurgia da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
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12
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McCann M, Kelly AM, Eustace-Cook J, Howlin C, Daly L. Community nurses' attitudes, knowledge and educational needs in relation to urinary continence, continence assessment and management: A systematic review. J Clin Nurs 2021; 31:1041-1060. [PMID: 34296482 DOI: 10.1111/jocn.15969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/27/2021] [Accepted: 06/02/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To identify, appraise and summarise the available evidence relating to community nurses' attitudes, knowledge and educational needs in relation to urinary continence. BACKGROUND Community nurses play a pivotal role in identifying and supporting individuals who experience urinary continence issues. Gaps in nurses' continence-related education and knowledge may contribute to sub-optimal assessment and management across the continuum of care. DESIGN A systematic review. METHODS MEDLINE, CINAHL Complete and EMBASE were searched from inception to November 2020; keywords used included community nurses, urinary continence, incontinence, knowledge, attitude and education needs. Given the degree of heterogeneity between included studies, a meta-analysis was not feasible. Included studies were critically evaluated; key study characteristics and findings pertinent to the review purpose were summarised. The review adhered to the PRISMA 2020 checklist. RESULTS Four studies reported in six papers were included. Community nurses lacked knowledge in certain areas of urinary continence and incontinence. Nurses reported they were adequately prepared but without sufficient knowledge to effectively care for those with urinary incontinence. Community nurses' attitudes to urinary incontinence were generally positive, but they demonstrated misconceptions that urinary incontinence was inevitable and less distressing for older people. CONCLUSIONS There is limited research exploring community nurses' knowledge, attitudes and education needs in relation to urinary continence and incontinence care. Community nurses may have knowledge gaps and less favourable attitudes to some aspects of urinary continence care.
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Affiliation(s)
- Margaret McCann
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | | | | | - Claire Howlin
- Trinity Centre for Practice and Healthcare Innovation, Trinity College Dublin, Dublin, Ireland
| | - Louise Daly
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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13
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Miyazato M, Ashikari A, Nakamura K, Nakamura T, Yamashiro K, Uema T, Uehara M, Masuzaki H, Saito S, Maeda S, Ishida H, Matsushita M. Effect of a mobile digital intervention to enhance physical activity in individuals with metabolic disorders on voiding patterns measured by 24-h voided volume monitoring system: Kumejima Digital Health Project (KDHP). Int Urol Nephrol 2021; 53:1497-1505. [PMID: 33909235 PMCID: PMC8280019 DOI: 10.1007/s11255-021-02867-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/17/2021] [Indexed: 11/09/2022]
Abstract
Purpose To evaluate the effect of a mobile digital intervention on voiding patterns, we performed 24-h voided volume monitoring in individuals with metabolic disorders. Methods Participants with metabolic disorders were grouped into either the intervention group (n = 17), who had access to a smartphone app (CARADA), or the non-intervention group (n = 11), who did not. Urine monitoring was conducted for 24 h using a novel digital self-health monitoring system for urine excretion (s-HMSU). Body weight, abdominal circumference, blood pressure, and biomarkers were measured. Results Physical findings and blood test results at baseline and 6 months indicated no significant between-group differences. Night-time frequency did not change between baseline and 6 months in the intervention group but significantly worsened at 6 months in the non-intervention group, as compared to baseline (1.0 ± 0.7 vs. 1.5 ± 0.5, p < 0.05). The change in night-time frequency over 6 months did not differ between the intervention and non-intervention groups. Furthermore, the change in hours of undisturbed sleep over 6 months did not differ between the two groups. However, compared with baseline, nocturnal polyuria index tended to worsen at 6 months in the non-intervention group. Conclusion Our study results suggest that mobile digital intervention might be useful for behavioral therapy to improve night-time frequency and urine production and that s-HMSU might be beneficial for confirming the prevention of progress in individuals with metabolic disorders, which can aid in modifying lifestyle.
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Affiliation(s)
- Minoru Miyazato
- Department of Systems Physiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
| | - Asuka Ashikari
- Department of Urology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Koshi Nakamura
- Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Takehiro Nakamura
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kiyoto Yamashiro
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Tsugumi Uema
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Moriyuki Uehara
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hiroaki Masuzaki
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Seiichi Saito
- Department of Urology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Shiro Maeda
- Department of Advanced Genomic and Laboratory Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.,Division of Clinical Laboratory and Blood Transfusion, University of the Ryukyus Hospital, Okinawa, Japan
| | - Hajime Ishida
- Department of Human Biology and Anatomy, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Masayuki Matsushita
- Department of Molecular and Cellular Physiology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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14
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Mass-Lindenbaum M, Calderón-Pollak D, Goldman HB, Pizarro-Berdichevsky J. Sacral neuromodulation - when and for who. Int Braz J Urol 2021; 47:647-656. [PMID: 33621015 PMCID: PMC7993957 DOI: 10.1590/s1677-5538.ibju.2021.99.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/10/2020] [Indexed: 01/14/2023] Open
Affiliation(s)
| | | | - H B Goldman
- Glickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Javier Pizarro-Berdichevsky
- Centro de Innovación en Piso Pélvico, Hospital Sótero del Río, Santiago, Chile.,Division de Obstetricia y Ginecología, Hospital Sótero del Río, Pontificia Universidad Católica de Chile, Santiago, Chile
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15
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Park GH, Kim SJ, Cho YS. Development of a voiding diary using urination recognition technology in mobile environment. J Exerc Rehabil 2021; 16:529-533. [PMID: 33457390 PMCID: PMC7788254 DOI: 10.12965/jer.2040790.395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/05/2020] [Indexed: 11/30/2022] Open
Abstract
We invented a wearable device that can measure voiding time and frequency by checking a habitual series of characteristic motions among men. This study collected and analyzed urination time data collected smart bands worn by patients to resolve the clinical issues posed by using voiding charts. By developing a smart band-based algorithm for assessing urination time in patients, this study aimed to explore the feasibility of urination management systems. This study aimed to assess urination time based on a patient’s posture and changes in posture. Motion data were obtained from a smart band on the arm. An algorithm that identifies the three stages of urination (forward movement, urination, backward movement) was developed based on data collected from a 3-axis accelerometer and tilt angle data. Therefore, we analyze hidden Markov model (HMM)-based sequential data to determine urination time. Real-time data were acquired from the smart band. For data corresponding to a specific duration, the value of the signals was calculated and then compared with the set analysis model to calculate the time of urination. The final accuracy of the algorithm was calculated based on clinical guidelines for urologists. The experiment showed a high average accuracy of 92.5%, proving the robustness of the proposed algorithm. The proposed urination time recognition technology draws on acceleration data and tilt angle data collected via a smart band; these data were then analyzed using a classifier after applying the HMM method.
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Affiliation(s)
- Gun Hyun Park
- Department of Urology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Su Jin Kim
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Sam Cho
- Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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16
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Zyczynski HM, Richter HE, Sung VW, Arya LA, Lukacz ES, Visco AG, Rahn DD, Carper B, Mazloomdoost D, Gantz MG. Performance, acceptability, and validation of a phone application bowel diary. Neurourol Urodyn 2020; 39:2480-2489. [PMID: 32960998 DOI: 10.1002/nau.24520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/07/2020] [Indexed: 12/11/2022]
Abstract
AIMS To assess performance, acceptability, external validity, and reliability of a phone application electronic bowel diary (PFDN Bowel eDiary). METHODS Women reporting refractory accidental bowel leakage (ABL) were enrolled in a randomized, crossover trial evaluating paper versus eDiary documentation of bowel movements (BM) and fecal incontinence episodes (FIE). Events were characterized by the presence or absence of urgency and Bristol stool scale consistency. The eDiary entries were date/time stamped and prompted by twice-daily phone notifications. Women were randomized to complete up to three consecutive 14-day diaries in two sequences. Diary events were compared between formats using the Pearson correlation. System usability scale (SUS) assessed eDiary usability. The eDiary test-retest reliability was assessed with intraclass correlations (ICCs). RESULTS Paired diary data were available from 60/69 (87%) women 63.8 ± 9.8 years old with mean 13.2 BM per week and 6.5 FIE per week (nearly half with urgency). Among those providing diaries, adherence did not differ by paper or eDiary (93.3% vs. 95.0%). Notifications prompted 29.6% of eDiary entries, improving adherence from 70% to 95%. Paper and eDiaries were moderate to-strongly correlated for BMs per week (r = .61), urgency BMs per week (r = .76), FIE per week (r = .66), urgency FIE per week (r = .72). Test-retest reliability was good (ICC = .81 BMs per week, .79 urgency BMs per week, .74 FIE per week, and .62 urgency FIE per week). The mean SUS score was high, 82.3 ± 17.5 (range, 0-100) with 91.4% rating it easy to use, and 75.9% preferring the eDiary over paper. CONCLUSION The PFDN Bowel eDiary correlated well with paper diary was considered easy to use, preferred to paper diaries, had high rates of confirmed real-time diary completion that obviated staff data entry.
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Affiliation(s)
- Halina M Zyczynski
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh/Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
| | - Holly E Richter
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Vivian W Sung
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women's and Infants Hospital, Providence, Rhode Island, USA
| | - Lily A Arya
- Department of Obstetrics and Gynecology, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Emily S Lukacz
- Department of Reproductive Medicine, UC San Diego Health Care System, San Diego, California, USA
| | - Anthony G Visco
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA
| | - David D Rahn
- Department of Obstetrics and Gynecology, University of Texas Southwestern, Dallas, Texas, USA
| | - Benjamin Carper
- Biostatistics and Epidemiology Division, RTI International, Durham, NC, USA
| | - Donna Mazloomdoost
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Marie G Gantz
- Biostatistics and Epidemiology Division, RTI International, Durham, NC, USA
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Baines G, Araklitis G, Flint R, Robinson D, Cardozo L. What affects the placebo effect? Eur J Obstet Gynecol Reprod Biol 2020; 246:134-137. [DOI: 10.1016/j.ejogrb.2020.01.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/13/2020] [Accepted: 01/20/2020] [Indexed: 11/27/2022]
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18
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Gracies JM, Pradines M, Ghédira M, Loche CM, Mardale V, Hennegrave C, Gault-Colas C, Audureau E, Hutin E, Baude M, Bayle N. Guided Self-rehabilitation Contract vs conventional therapy in chronic stroke-induced hemiparesis: NEURORESTORE, a multicenter randomized controlled trial. BMC Neurol 2019; 19:39. [PMID: 30871480 PMCID: PMC6419473 DOI: 10.1186/s12883-019-1257-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 02/14/2019] [Indexed: 12/30/2022] Open
Abstract
Background After discharge from hospital following a stroke, prescriptions of community-based rehabilitation are often downgraded to “maintenance” rehabilitation or discontinued. This classic therapeutic behavior stems from persistent confusion between lesion-induced plasticity, which lasts for the first 6 months essentially, and behavior-induced plasticity, of indefinite duration, through which intense rehabilitation might remain effective. This prospective, randomized, multicenter, single-blind study in subjects with chronic stroke-induced hemiparesis evaluates changes in active function with a Guided Self-rehabilitation Contract vs conventional therapy alone, pursued for a year. Methods One hundred and twenty four adult subjects with chronic hemiparesis (> 1 year since first stroke) will be included in six tertiary rehabilitation centers. For each patient, two treatments will be compared over a 1-year period, preceded and followed by an observational 6-month phase of conventional rehabilitation. In the experimental group, the therapist will implement the diary-based and antagonist-targeting Guided Self-rehabilitation Contract method using two monthly home visits. The method involves: i) prescribing a daily antagonist-targeting self-rehabilitation program, ii) teaching the techniques involved in the program, iii) motivating and guiding the patient over time, by requesting a diary of the work achieved to be brought back by the patient at each visit. In the control group, participants will benefit from conventional therapy only, as per their physician’s prescription. The two co-primary outcome measures are the maximal ambulation speed barefoot over 10 m for the lower limb, and the Modified Frenchay Scale for the upper limb. Secondary outcome measures include total cost of care from the medical insurance point of view, physiological cost index in the 2-min walking test, quality of life (SF 36) and measures of the psychological impact of the two treatment modalities. Participants will be evaluated every 6 months (D1/M6/M12/M18/M24) by a blinded investigator, the experimental period being between M6 and M18. Each patient will be allowed to receive any medications deemed necessary to their attending physician, including botulinum toxin injections. Discussion This study will increase the level of knowledge on the effects of Guided Self-rehabilitation Contracts in patients with chronic stroke-induced hemiparesis. Trial registration ClinicalTrials.gov: NCT02202954, July 29, 2014.
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Affiliation(s)
- Jean-Michel Gracies
- EA 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), F-94010, Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94010, Créteil, France
| | - Maud Pradines
- EA 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), F-94010, Créteil, France. .,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94010, Créteil, France.
| | - Mouna Ghédira
- EA 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), F-94010, Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94010, Créteil, France
| | - Catherine-Marie Loche
- AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94010, Créteil, France
| | - Valentina Mardale
- AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94010, Créteil, France
| | - Catherine Hennegrave
- AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94010, Créteil, France
| | - Caroline Gault-Colas
- AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94010, Créteil, France
| | - Etienne Audureau
- AP-HP, Service de Santé Publique, Hôpitaux Universitaires Henri Mondor, F-94010, Créteil, France.,DHU A-TVB, IRMB- EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit), Université Paris Est-Créteil, F-94010, Créteil, France
| | - Emilie Hutin
- EA 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), F-94010, Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94010, Créteil, France
| | - Marjolaine Baude
- EA 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), F-94010, Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94010, Créteil, France
| | - Nicolas Bayle
- EA 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), F-94010, Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94010, Créteil, France
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Miyazato M, Yonemoto K, Ashikari A, Saito S, Yamashiro K, Uehara M, Masuzaki H, Ishida H, Matsushita M. Validation of a novel digital health monitoring system to measure the volume of voided urine. Neurourol Urodyn 2019; 38:1106-1110. [PMID: 30848839 DOI: 10.1002/nau.23965] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/19/2019] [Accepted: 02/14/2019] [Indexed: 11/08/2022]
Abstract
AIM To validate a novel digital health monitoring system to measure the volume of voided urine. METHODS Micturition volume was calculated using our novel digital self-health monitoring system of urine excretion (s-HMSU) in 18 participants (16 women and 2 men; average age, 40.8 years), without a history of voiding symptoms. Participants completed a self-reported questionnaire regarding their medical history and water intake during the period of observation, as well as the Core Lower Urinary Tract Symptom Score (CLSS) questionnaire. To assess the reliability of the voided volumes measured using the s-HMSU, the intraclass correlation coefficient (ICC) was calculated between the volume and the change in body weight before and after micturition. RESULTS The CLSS questionnaire confirmed the absence of urinary system diseases in all participants. The medical history was also negative with the exception of hypertension in one participant. The ICC (1,1) between the measured volume of urine excretion using the s-HMSU and the change in body weight was 0.972 (95% confidence interval, 0.957-0.982). CONCLUSIONS The s-HMSU system provides a reliable measure of voiding volume and is appropriate for home use. It has the potential to facilitate large-scale clinical research to examine the relationship between medical diseases and voiding dysfunction.
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Affiliation(s)
- Minoru Miyazato
- Department of Urology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Koji Yonemoto
- Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.,Division of Biostatistics, School of Health Sciences, Okinawa, Japan
| | - Asuka Ashikari
- Department of Urology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Seiichi Saito
- Department of Urology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kiyoto Yamashiro
- Kumejima Public Hospital, Okinawa, Japan.,Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Medicine), Okinawa, Japan
| | - Moriyuki Uehara
- Kumejima Public Hospital, Okinawa, Japan.,Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Medicine), Okinawa, Japan
| | - Hiroaki Masuzaki
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Medicine), Okinawa, Japan
| | - Hajime Ishida
- Department of Human Biology and Anatomy, University of the Ryukyus, Okinawa, Japan
| | - Masayuki Matsushita
- Department of Molecular and Cellular Physiology, University of the Ryukyus, Okinawa, Japan
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20
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Herrewegh A, Vork L, Eurelings E, Leue C, Kruimel J, van Koeveringe G, Vrijens D. The development of a patient-reported outcome measure for real-time symptom assessment in a population with functional urologic complaints-A focus group study. Neurourol Urodyn 2018; 37:2893-2903. [PMID: 30187953 DOI: 10.1002/nau.23808] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 08/09/2018] [Indexed: 12/12/2022]
Abstract
AIMS In the current diagnostic process for overactive bladder syndrome (OAB), biased retrospective questionnaires are often used. There is a need for a new assessment tool that embraces the heterogeneity of the OAB complex. A momentary assessment tool, the Experience Sampling Method (ESM) is promising, capturing random repetitive measurements during the day in the context of daily life and is capable to measure potential contextual triggers and psychological aspects. A focus group study was set up to evaluate which items should be implemented in a urological ESM. METHODS Focus group interviews were arranged, to assess the suitability and comprehensibility of a newly developed urological patient-reported outcome measurement (PROM), "Uromate." "Uromate" was created based on ESM literature. A multidisciplinary expert meeting was conducted to gain consensus on item relevance. RESULTS The initial ESM questionnaire contained 58 items, but was eventually reduced to 39 items after focus group sessions and expert meeting. Thirty-seven items are repeated questions, including three gender-dependent items. Two items are one-time questions about the use of incontinence material. Additionally, a morning questionnaire was included. Depending on the symptom pattern, a minimum of 26 items and a maximum of 36 items will be repeatedly assessed with "Uromate." CONCLUSION There is a need for a modern assessment tool for OAB which overcomes the limitations of today's retrospective questionnaires. Therefore, a urological ESM tool, the "Uromate," is being developed as a PROM, following the FDA PROM development guidelines, to measure real-time symptoms in the context of daily life.
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Affiliation(s)
- Alexandra Herrewegh
- Department of Urology, Maastricht University Medical Center+, Maastricht, The Netherlands.,Pelvic Care Center, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Lisa Vork
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Eline Eurelings
- Department of Psychiatry and Medical Psychology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Carsten Leue
- Pelvic Care Center, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Psychiatry and Medical Psychology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Joanna Kruimel
- Pelvic Care Center, Maastricht University Medical Center+, Maastricht, The Netherlands.,Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Gommert van Koeveringe
- Department of Urology, Maastricht University Medical Center+, Maastricht, The Netherlands.,Pelvic Care Center, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Desiree Vrijens
- Department of Urology, Maastricht University Medical Center+, Maastricht, The Netherlands.,Pelvic Care Center, Maastricht University Medical Center+, Maastricht, The Netherlands
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Herschorn S, Staskin D, Tu LM, Fialkov J, Walsh T, Gooch K, Schermer CR. Patient-reported outcomes in patients with overactive bladder treated with mirabegron and tolterodine in a prospective, double-blind, randomized, two-period crossover, multicenter study (PREFER). Health Qual Life Outcomes 2018; 16:69. [PMID: 29673355 PMCID: PMC5909214 DOI: 10.1186/s12955-018-0892-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/05/2018] [Indexed: 12/29/2022] Open
Abstract
Background The PREFER study was an assessment of medication tolerability, treatment preference and symptom improvement during treatment with mirabegron (M) and tolterodine (T) extended release (ER) in patients with overactive bladder (OAB). In this analysis of PREFER, patient-reported outcomes (PROs) were assessed during treatment. Methods PREFER was a two-period, 8-week crossover, double-blind, phase IV study (NCT02138747) of treatment-naïve adults with OAB ≥3 months randomized to 1 of 4 treatment sequences (M/T; T/M; M/M; T/T), separated by a 2-week washout. Tolterodine ER was dosed at 4 mg for 8 weeks and mirabegron was dosed at 25 mg for 4 weeks then increased to 50 mg for the next 4 weeks. At each visit, PROs related to treatment satisfaction, quality of life and symptom bother were assessed using the OAB Satisfaction (OAB-S; 3 independent scales/5 single-item overall assessments), OAB-q (total health-related QoL [HRQoL] and subscales [Sleep, Social, Coping, Concern] and Symptom Bother scale) and Patient Perception of Bladder Condition (PPBC) questionnaires. Responder rates were reported for OAB-q subscales based on a minimal important difference (MID; ≥ 10-point improvement) and OAB-S Medication Tolerability score ≥ 90. Results In total, 358 randomized patients received ≥1 dose of double-blind study medication and completed ≥1 post-baseline value (OAB-S scale, OAB-q, PPBC): M/T (n = 154), T/M (n = 144), M/M (n = 30) or T/T (n = 30). At end of treatment (EoT), mirabegron and tolterodine ER were associated with similar mean improvements in 7 of the 8 OAB-S scores investigated, OAB-q scales and PPBC. A higher percentage of patients achieved clinically relevant improvements (MID) in OAB-q scales and OAB-S Medication Tolerability score during treatment with mirabegron than tolterodine ER. Conclusions On average, patients with OAB experienced improvements in treatment satisfaction, HRQoL and symptom bother that were of a similar magnitude during treatment with mirabegron or tolterodine ER. However, during mirabegron treatment, patients were more likely to achieve clinically relevant improvements in tolerability and HRQoL (as measured by the MID for the OAB-q or an OAB-S Medication Tolerability score ≥ 90) than during tolterodine ER treatment. Trial registration NCT02138747; registered May 13, 2014.
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Affiliation(s)
- Sender Herschorn
- Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, MG408, Toronto, Ontario, M4N 3M5, Canada.
| | - David Staskin
- Tufts University School of Medicine, Boston, MA, USA
| | - Le Mai Tu
- University of Sherbrooke, Quebec, Canada
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22
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Goldman HB, Lloyd JC, Noblett KL, Carey MP, Castaño Botero JC, Gajewski JB, Lehur PA, Hassouna MM, Matzel KE, Paquette IM, de Wachter S, Ehlert MJ, Chartier-Kastler E, Siegel SW. International Continence Society best practice statement for use of sacral neuromodulation. Neurourol Urodyn 2018; 37:1823-1848. [PMID: 29641846 DOI: 10.1002/nau.23515] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 01/04/2018] [Indexed: 12/31/2022]
Abstract
AIMS Sacral neuromodulation (SNM) is an accepted therapy for a variety of conditions. However, despite over 20 years of experience, it remains a specialized procedure with a number of subtleties. Here we present the recommendations issued from the International Continence Society (ICS) SNM Consensus Panel. METHODS Under the auspices of the ICS, eight urologists, three colorectal surgeons and two urogynecologists, covering a wide breadth of geographic and specialty interest representation, met in January 2017 to discuss best practices for neuromodulation. Suggestions for statements were submitted in advance and specific topics were assigned to committee members, who prepared and presented supporting data to the group, at which time each topic was discussed in depth. Best practice statements were formulated based on available data. This document was then circulated to multiple external reviewers after which final edits were made and approved by the group. RESULTS The present recommendations, based on the most relevant data available in the literature, as well as expert opinion, address a variety of specific and at times problematic issues associated with SNM. These include the use of SNM for a variety of underlying conditions, need for pre-procedural testing, use of staged versus single-stage procedures, screening for success during the trial phase, ideal anesthesia, device implantation, post-procedural management, trouble-shooting loss of device function, and future directions for research. CONCLUSIONS These guidelines undoubtedly constitute a reference document, which will help urologists, gynecologists, and colorectal surgeons optimize their use of SNM for refractory urinary urgency and frequency, UUI, NOR, and FI.
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Affiliation(s)
- Howard B Goldman
- Glickman Urology and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jessica C Lloyd
- Glickman Urology and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Karen L Noblett
- Axonics Modulation Technologies and Department of Obstetrics and Gynecology, University of California-Irvine, Irvine, California
| | - Marcus P Carey
- Division of Urogynaecology, Frances Perry House, Parkville, Victoria, Australia
| | | | - Jerzy B Gajewski
- Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Paul A Lehur
- Clinique de Chirurgie Digestive et Endocrinienne, Universite de Nantes, Nantes, France
| | - Magdy M Hassouna
- Division of Urology, University of Toronto, Toronto, Ontario, Canada
| | - Klaus E Matzel
- Division of Coloproctology, University of Erlangen, Erlangen, Germany
| | - Ian M Paquette
- Department of Surgery, Division of Colon and Rectal Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Stefan de Wachter
- Department of Urology, University Hospital Antwerpen, University of Antwerpen, Belgium
| | | | - Emmanuel Chartier-Kastler
- Department of Urology, Academic Hospital Pitié-Salpétrière, Medical School Sorbonne Université, Paris, France ECK
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23
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Robinson D, Kelleher C, Staskin D, Mueller ER, Falconer C, Wang J, Ridder A, Stoelzel M, Paireddy A, van Maanen R, Hakimi Z, Herschorn S. Patient-reported outcomes from SYNERGY, a randomized, double-blind, multicenter study evaluating combinations of mirabegron and solifenacin compared with monotherapy and placebo in OAB patients. Neurourol Urodyn 2017; 37:394-406. [PMID: 28704584 DOI: 10.1002/nau.23315] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/25/2017] [Indexed: 11/12/2022]
Abstract
AIMS To evaluate patient-reported outcomes (PROs) of combinations of solifenacin and mirabegron compared with solifenacin and mirabegron monotherapy and with placebo in patients with overactive bladder (OAB) from the SYNERGY trial. METHODS Following a 4-week placebo run-in, period patients (≥18 years) with OAB were randomized 2:2:1:1:1:1 to receive solifenacin 5 mg + mirabegron 25 mg (combination 5 + 25 mg), solifenacin 5 mg + mirabegron 50 mg, (combination 5 + 50 mg), solifenacin 5 mg, mirabegron 25 mg, mirabegron 50 mg or placebo for 12 weeks, followed by a 2-week washout period. At each visit, PROs related to quality of life, symptom bother, and treatment satisfaction were assessed, including OAB-q Symptom Bother score, health-related quality of life (HRQOL) Total score, treatment satisfaction-visual analogue scale (TS-VAS), and patient perception of bladder condition (PPBC) questionnaires. RESULTS Overall, 3527 patients were randomized into the study, with 3494 receiving double-blind treatment. At end of treatment (EoT), both combination groups showed greater improvements in OAB-q Symptom Bother score compared with the monotherapy groups (nominal P < 0.001). Statistically significant improvements in HRQOL Total scores were observed in the combination groups versus monotherapy groups (P ≤ 0.002). For both combination groups, the OAB-q Symptom Bother score responder rates at EoT were statistically significantly higher versus mirabegron monotherapy (P < 0.05). The mean adjusted changes from baseline to EoT for PPBC were greater in the combination groups compared with monotherapy groups. CONCLUSIONS PROs showed that combination therapy provided clear improvements and an additive effect for many HRQOL parameters, including OAB-q Symptom Bother score, HRQOL Total score, and PPBC.
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Affiliation(s)
| | | | - David Staskin
- Tufts University School of Medicine, Boston, Massachusetts
| | | | | | | | - Arwin Ridder
- Astellas Pharma Global Development, Leiden, Netherlands
| | | | - Asha Paireddy
- Astellas Pharma Global Development, Leiden, Netherlands
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24
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Are Bladder Diaries Helpful in Management of Overactive Bladder? CURRENT BLADDER DYSFUNCTION REPORTS 2016. [DOI: 10.1007/s11884-016-0343-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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