Mp23-12 Optimizing Remote Access to Urinary Incontinence Treatments for Women Veterans: A Sequential, Multiple Assignment, Randomized Multicenter Trial

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence (MP23)1 May 2024MP23-12 OPTIMIZING REMOTE ACCESS TO URINARY INCONTINENCE TREATMENTS FOR WOMEN VETERANS: A SEQUENTIAL, MULTIPLE ASSIGNMENT, RANDOMIZED MULTICENTER TRIAL Alayne D. Markland, Karen Goldstein, T. Mark Beasley, Lisa Zubkoff, Ursula Kelly, Kathryn L. Burgio, and E. Camille Vaughan Alayne D. MarklandAlayne D. Markland , Karen GoldsteinKaren Goldstein , T. Mark BeasleyT. Mark Beasley , Lisa ZubkoffLisa Zubkoff , Ursula KellyUrsula Kelly , Kathryn L. BurgioKathryn L. Burgio , and E. Camille VaughanE. Camille Vaughan View All Author Informationhttps://doi.org/10.1097/01.JU.0001008776.99097.8a.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Behavioral treatments for urinary incontinence (UI) are recommended as first-line treatment options. Yet, many women with UI do not seek treatment. To improve access to behavioral treatments for UI, we compared the effectiveness of two remote delivery modalities and assessed the effect of an additional randomized video visit for non-responders. METHODS: Nonpregnant women Veterans with UI who had email access were eligible. Recruitment took place at 3 Veterans Affairs (VA) healthcare systems. Interventions included: (1) mobile health UI application (MyHealtheBladder;MHB) with daily sessions over 8-weeks and (2) a single VA Video Connect (VVC) session delivered by trained UI providers. Randomization groups were stratified by International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short-Form scores (ICIQ-UI-SF; range 0-21; lower scores=improved UI symptoms). The primary outcome was ICIQ-UI change scores at 12-weeks. Non-responders to initial treatment at 8 weeks (ICIQ-UI change scores>2.5 points) were re-randomized to an additional VVC session or to continue current treatment. RESULTS: Of the 286 women Veterans randomized, 164 (56.4%) self-identified as Black/African American, and the mean age was 52.9±11.3 years (range 33-83). The 12-week questionnaire response rate was 70.0% (200 of 286). At 12-weeks of follow-up (Table 1), ICIQ-UI scores for the MHB group (n=100 of 147) changed by -3.6±3.9 points vs -2.3±4.0 points for the VVC group (n=100 of 139), p=0.02. At 12-weeks, ICIQ-UI scores for the MHB non-responder group re-randomized to an additional VVC (n=12) changed -1.0±2.6 points vs -1.2±3.5 points for the MBH non-responders who continued treatment (n=10), p=0.14. In the VVC non-responder group with the additional VVC (n=23), ICIQ-UI scores changed -0.9±2.8 points vs -0.3±4.2 in VVC non-responders who continued treatment (n=30), p=0.58. CONCLUSIONS: Engaging women Veterans with virtual modalities for delivery of behavioral UI treatment improved UI symptoms, with more improvement for MHB compared to VVC. Optimization of UI treatment with an additional video visit did not improve UI symptoms for non-responders. Remote delivery of UI treatments is effective for improving UI among women in the VA healthcare system. Source of Funding: Department of Veterans Affairs Health Services Research and Development HX002827 (PI: Markland); ClinicalTrials.gov number-NCT04237753 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e386 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Alayne D. Markland More articles by this author Karen Goldstein More articles by this author T. Mark Beasley More articles by this author Lisa Zubkoff More articles by this author Ursula Kelly More articles by this author Kathryn L. Burgio More articles by this author E. Camille Vaughan More articles by this author Expand All Advertisement PDF downloadLoading ...