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Janela D, Areias AC, Molinos M, Moulder RG, Magalhães I, Bento V, Cardeano M, Yanamadala V, Correia FD, Atherton J, Costa F. Digital Care Program for Urinary Incontinence in Females: A Large-Scale, Prospective, Cohort Study. Healthcare (Basel) 2024; 12:141. [PMID: 38255031 PMCID: PMC10815799 DOI: 10.3390/healthcare12020141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 01/24/2024] Open
Abstract
Female urinary incontinence (UI) is highly prevalent in the US (>60%). Pelvic floor muscle training (PFMT) represents first-line care for UI; however, access and adherence challenges urge new care delivery models. This prospective cohort study investigates the feasibility and safety of a remote digital care program (DCP) combining education and PFMT with real-time biofeedback with an average duration of 10 weeks. The primary outcome was the change in the Urinary Impact Questionnaire-short form (UIQ-7) from baseline to program-end, calculated through latent growth curve analysis (LGCA). Secondary outcomes included the impact of pelvic conditions (PFIQ-7), depression (PHQ-9), anxiety (GAD-7), productivity impairment (WPAI), intention to seek additional healthcare, engagement, and satisfaction. Of the 326 participants who started the program, 264 (81.0%) completed the intervention. Significant improvement on UIQ-7 (8.8, 95%CI 4.7; 12.9, p < 0.001) was observed, corresponding to a response rate of 57.3%, together with improvements in all other outcomes and high satisfaction (8.9/10, SD 1.8). This study shows the feasibility and safety of a completely remote DCP with biofeedback managed asynchronously by a physical therapist to reduce UI-related symptoms in a real-world setting. Together, these findings may advocate for the exploration of this care delivery option to escalate access to proper and timely UI care.
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Affiliation(s)
- Dora Janela
- Clinical Research, Sword Health Inc., Draper, UT 84020, USA; (D.J.); (A.C.A.); (M.M.); (R.G.M.); (V.B.); (V.Y.); (F.D.C.)
| | - Anabela C. Areias
- Clinical Research, Sword Health Inc., Draper, UT 84020, USA; (D.J.); (A.C.A.); (M.M.); (R.G.M.); (V.B.); (V.Y.); (F.D.C.)
| | - Maria Molinos
- Clinical Research, Sword Health Inc., Draper, UT 84020, USA; (D.J.); (A.C.A.); (M.M.); (R.G.M.); (V.B.); (V.Y.); (F.D.C.)
| | - Robert G. Moulder
- Clinical Research, Sword Health Inc., Draper, UT 84020, USA; (D.J.); (A.C.A.); (M.M.); (R.G.M.); (V.B.); (V.Y.); (F.D.C.)
- Institute for Cognitive Science, University of Colorado, Boulder, CO 80309, USA
| | - Ivo Magalhães
- Bloom, Sword Health Inc., Draper, UT 84020, USA; (I.M.); (M.C.); (J.A.)
| | - Virgílio Bento
- Clinical Research, Sword Health Inc., Draper, UT 84020, USA; (D.J.); (A.C.A.); (M.M.); (R.G.M.); (V.B.); (V.Y.); (F.D.C.)
| | - Marta Cardeano
- Bloom, Sword Health Inc., Draper, UT 84020, USA; (I.M.); (M.C.); (J.A.)
| | - Vijay Yanamadala
- Clinical Research, Sword Health Inc., Draper, UT 84020, USA; (D.J.); (A.C.A.); (M.M.); (R.G.M.); (V.B.); (V.Y.); (F.D.C.)
- Department of Surgery, Frank H. Netter School of Medicine, Quinnipiac University, Hamden, CT 06473, USA
- Department of Neurosurgery, Hartford Healthcare Medical Group, Westport, CT 06103, USA
| | - Fernando Dias Correia
- Clinical Research, Sword Health Inc., Draper, UT 84020, USA; (D.J.); (A.C.A.); (M.M.); (R.G.M.); (V.B.); (V.Y.); (F.D.C.)
- Neurology Department, Centro Hospitalar e Universitário do Porto, 4099-001 Porto, Portugal
| | - Jennesa Atherton
- Bloom, Sword Health Inc., Draper, UT 84020, USA; (I.M.); (M.C.); (J.A.)
| | - Fabíola Costa
- Clinical Research, Sword Health Inc., Draper, UT 84020, USA; (D.J.); (A.C.A.); (M.M.); (R.G.M.); (V.B.); (V.Y.); (F.D.C.)
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