Pilot Study of a Digital Behavioral Therapy for Overactive Bladder in Women

Celine Sooknarine; Sylvia Farrell; Susmita Sarma; Fadi Salameh; Naomi Burke; Brendan Staunton; Emma Carr; K Sexton; Gerry Agnew; Andrew Downey; Francis D'Arcy; Geoffrey W Cundiff

doi:10.1097/SPV.0000000000001499

Pilot Study of a Digital Behavioral Therapy for Overactive Bladder in Women

Urogynecology (Phila). 2024 Mar 7. doi: 10.1097/SPV.0000000000001499. Online ahead of print.

Authors

Affiliations

¹ From the RCSI University of Medicine and Health Sciences, Dublin.
² Evidence-Based Therapy Centre.
³ University Hospital, Galway.
⁴ Rotunda Hospital, Dublin.
⁵ Amara Therapeutics, Galway.
⁶ National Maternity Hospital, Dublin.
⁷ Galway University Hospital, Galway, Ireland.

PMID: 38465995
DOI: 10.1097/SPV.0000000000001499

Abstract

Importance: The burden and high prevalence of overactive bladder (OAB) underline the urgent need for effective treatment. This study provides an initial look at an alternative approach to behavioral therapy for overactive bladder (OAB) that is delivered as an app on a smartphone.

Objective: This study aimed to investigate feasibility, acceptability, and preliminary efficacy of a digital therapeutic for OAB.

Study design: This was a multicentered prospective pilot study. We used a convenience sample (N = 30) from waiting lists of women referred for incontinence, excluding urinary tract infections, urinary retention, bladder pain syndrome, pelvic cancer, current pregnancy, kidney disease, dementia, stroke, and prior neuromodulation. The intervention, a smartphone app, provided an 8-week program with weekly modules combining evidence-based knowledge videos and skill-building exercises that incorporated behavioral therapy, cognitive behavioral therapy, pelvic muscle training, and general health information. Combined scores on the International Consultation on Incontinence Questionnaire was the primary outcome measure. Secondary outcomes included improvement in quality of life, based on International Consultation on Incontinence Questionnaire, a 72-hour urinary diary, and Patient Global Impression of Improvement. We evaluated usability with the Mobile Application Rating Scale. Statistical tests included Shapiro-Wilk tests and paired-sample t tests.

Results: Overall, 100% of participants reported a reduction in their OAB symptoms and 82% reported an improvement in quality of life. There was a significant improvement in diary parameters, including frequency (10.19-6.71 a day: SD, 1.25; P = 0.017) and incontinence (10-3.57: SD, 4.58). Participants rated the app highly on functionality, and 70% would recommend it. Patient Global Impression of Improvement improved for 72% of participants.

Conclusions: This study supports the application of a digital platform to over-come the real-world barriers for first-line treatment for OAB and offers information to inform further evaluation of the safety and efficacy of the NUIG OAB App.