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Information and Communication Technologies (ICT) self-management system for pelvic floor muscle training: a pilot study in women with stress urinary incontinence
IUGA Academy. Anglès Acedo S. Jun 30, 2018; 213242; 142 Topic: Stress Incontinence
Dr. Sònia Anglès Acedo
Dr. Sònia Anglès Acedo

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142

Information and Communication Technologies (ICT) self-management system for pelvic floor muscle training: A pilot study in women with stress urinary incontinence

Anglès Acedo, S1; Kastelein, AW2; Ros Cerro, C1; Raatikainen, K3; Alonso Lopez, JF4; Pagès Raventos, A4; Vodegel, EV2; Airaksinen, O3; Espuña Pons, M1

1: Hospital Clínic de Barcelona; 2: Academic Medical Center; 3: Kuopio University Hospital; 4: Universitat Politècnica de Catalunya

Introduction: Information and Communication Technologies (ICT) applied to healthcare systems can increase the accessibility to treatments, empower patients and healthcare workers and invest in research towards the personalized medicine of the future. E-Health tools for urinary incontinence (UI), scientifically evaluated, could provide an effective and widely accepted treatment.

Objective: The main objective of this pilot study is to perform a thorough test of the functionality of the ICT self-management system in order to analyze its technical readiness, for clinical use and research purposes. The video will show all the components of the ICT-system and how it works.

Methods: 21 women, between 18 to 75 years old, with mild or moderate stress urinary incontinence (SUI) according to their answers to the UDI-6 and ICIQ-UI-SF questionnaires, were recruited in two European University Hospitals. All patients received information about all treatments options for SUI and accepted to be treated with conservative treatment. Informed consent was obtained for using the ICT self-management system for pelvic floor muscle training (PFMT) at home during three months.

This system integrates: 1) Portable vaginal biofeedback device and abdominal belt with surface electromyography (EMG)-sensors to collect data on patient’s pelvic floor and abdominal muscle activity; 2) Smartphone with application and serious games, designed specially to facilitate and support conservative treatment for SUI; 3) A web portal to remotely supervise the sessions adherence, to monitor progress and to communicate with patients.

All patients performed a training program designed by a therapist. During the treatment, patients reported clinical and technical issues, related to the ICT self-management system and filled out specific questionnaires to evaluate functionality and usability of the system based on their experience.

Results: 21 women were included, age ranging from 32 to 67 years (median 45) with a median BMI of 23 kg/m2, a median parity of 2 and a median ICIQ-UI-SF of 11 (IQR 9-12). None of the patients reported problems regarding the use of the ICT self-management system. There were six dropouts, three for technical issues and three for personal reasons (non-medical). The 15 patients who completed the treatment had an adherence of 70,4% (range 41,8-86,2%). During this evaluation of the systems’ functionality, we observed different minor technical issues mainly related to software calculations and fatigue of the materials used in the prototype. All issues were resolved, which consequently improved the system. Only minor clinical events occurred (vaginitis, urinary infection). However, despite the technical issues, most patients (80%) were pleased or very pleased with the ICT self-management system.

Conclusions: Overall, the ICT-self-management system performed well in usability testing and guarantees good adherence to PFMT. In addition, it helps therapists to monitor their patients and communicate with them. Different minor technical issues were detected. All issues were resolved and their detection resulted in improved functionality of the ICT self-management system. Clinical issues related to treatment were minimal and similar to other vaginal devices.

Technical teams are implementing all improvements in order to develop the definitive ICT self-management system, which will be evaluated in a randomized clinical trial.

Disclosure:

Work supported by industry: no.

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