Pd43-12 a Non-Inferiority Trial for Telemedicine in the Management of Overactive Bladder

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Overactive Bladder I (PD43)1 May 2024PD43-12 A NON-INFERIORITY TRIAL FOR TELEMEDICINE IN THE MANAGEMENT OF OVERACTIVE BLADDER James M. Weinberger, Cindy Gu, Hannah Romeo, John Cabri, Lorna Kwan, Mehrnaz Siavoshi, and Victor W. Nitti James M. WeinbergerJames M. Weinberger , Cindy GuCindy Gu , Hannah RomeoHannah Romeo , John CabriJohn Cabri , Lorna KwanLorna Kwan , Mehrnaz SiavoshiMehrnaz Siavoshi , and Victor W. NittiVictor W. Nitti View All Author Informationhttps://doi.org/10.1097/01.JU.0001009568.19060.25.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Despite the increasing use of telemedicine (T) in Urology, its imprint on healthcare delivery has been limited. We designed a non-inferiority trial to delineate the use-case of T in the management of overactive bladder (OAB). This prospective, randomized trial aims to validate the T paradigm as a feasible alternative to traditional in-person (IP) visits, evaluating effectiveness, satisfaction, safety, and cost metrics. METHODS: 164 men and women with idiopathic OAB were prospectively enrolled and randomized to either the T or IP cohort. Patients completed standardized surveys at baseline and up to 6 consecutive follow-up visits to assess response to treatment and satisfaction. The primary outcome was the Treatment Satisfaction Visual Analogue Scale (TS-VAS); secondary outcomes included OABSS, PGII, PGIS, safety, patient burden (time and out-of-pocket costs), and progression to 3rd-line therapy. Groups were compared utilizing Fisher's exact, Median, and Kruskal-Wallis tests. RESULTS: The T arm comprised 84 patients across 209 visits. 80 patients were seen IP across 201 visits. The cohort was primarily female. There were no differences in demographics or clinical characteristics across arms. T was found to be non-inferior to IP for satisfaction (TS-VAS: IP 75.5 vs T 76.0, p=0.34). Treatment satisfaction was high across both cohorts, reflected in the TS-VAS, PGII and PGIS, which similarly showed non-inferiority. There was no difference in OABSS (p=0.43) or rate of progression to 3rd-line therapy. Total burden for patients favored T (Table 1). Utilization of urgent care, ER, or outside provider care visits for one's bladder condition was higher in the IP cohort (10.4% vs 1.3%, p=0.02). There was no difference in rate of loss to follow-up. CONCLUSIONS: In this prospective, randomized trial, the T approach for the management of overactive bladder was found to be non-inferior across patient satisfaction and efficacy, while demonstrating favorably in decreasing patient burden. Interestingly, the composite measure of safety showed higher utilization of outside care in the IP cohort. T offers an alternative option for care delivery for OAB that may result in improved satisfaction and compliance, and decreased cost, time, and travel burden for patients, allowing urologists to extend care to rural communities and non-mobile patients. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e903 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information James M. Weinberger More articles by this author Cindy Gu More articles by this author Hannah Romeo More articles by this author John Cabri More articles by this author Lorna Kwan More articles by this author Mehrnaz Siavoshi More articles by this author Victor W. Nitti More articles by this author Expand All Advertisement PDF downloadLoading ...