Cost-effectiveness of an app-based treatment for urinary incontinence in comparison with care-as-usual in Dutch general practice: a pragmatic randomised controlled trial over 12 months

Anne M M Loohuis; Henk Van Der Worp; Nienke J Wessels; Janny H Dekker; Marijke C Ph Slieker-Ten Hove; Marjolein Y Berger; Karin M Vermeulen; Marco H Blanker

doi:10.1111/1471-0528.17191

Cost-effectiveness of an app-based treatment for urinary incontinence in comparison with care-as-usual in Dutch general practice: a pragmatic randomised controlled trial over 12 months

Anne M M Loohuis^*, Henk Van Der Worp, Nienke J Wessels, Janny H Dekker, Marijke C Ph Slieker-Ten Hove, Marjolein Y Berger, Karin M Vermeulen, Marco H Blanker

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVE: To assess the cost-effectiveness of app-based treatment for female stress, urgency, or mixed urinary incontinence (UI) compared to care-as-usual in Dutch primary care.

DESIGN: A pragmatic, randomised controlled, superiority trial.

SETTING: Primary care in the Netherlands from 2015 to 2018, follow-up at 12 months.

POPULATION: Women with ≥2 UI-episodes per week, access to mobile apps, wanting treatment.

INTERVENTIONS: The standalone app included conservative management for UI with motivation aids (e.g., reminders). Care-as-usual delivered according to the Dutch GP guideline for UI.

MAIN OUTCOME MEASURES: Costs and cost-effectiveness and -utility were assessed from a societal perspective, based on Incontinence Impact Adjusted Life Years (IIALYs), Quality Adjusted Life years (QALYs) and medical, non-medical and productivity costs. Information on costs was obtained with the iMCQ and iPCQ questionnaires (Medical Consumption and Productivity Cost Questionnaires).

RESULTS: 262 women randomised equally to app or care-as-usual; 89 (68%) and 83 (63%) attended follow-up. Costs were lower for app-based treatment with €-161 (95%CI: -180 to -151) per year. Cost-effectiveness showed small mean differences in effect for IIALY (0.04) and QALY (-0.03) and thus larger ICER (-€3,696) and ICUR (€6,379) (Incremental Cost-Effectiveness and Cost-utility Ratios).

CONCLUSION: App-based treatment is a cost-effective alternative to care-as-usual for women with UI in Dutch primary care.

Original language	English
Pages (from-to)	1538-1545
Number of pages	8
Journal	BJOG : An International Journal of Obstetrics and Gynaecology
Volume	129
Issue number	9
Early online date	31-May-2022
DOIs	https://doi.org/10.1111/1471-0528.17191
Publication status	Published - Aug-2022

Keywords

app
cost-effectiveness
eHealth
general practice
long-term
pragmatic
primary care
self-management
urinary incontinence
INTERNET-BASED TREATMENT
WOMEN

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Top Publication award, BJOG one year cost-effectiveness
Loohuis, A. (Recipient), 2021
Prize › Academic

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Loohuis, A. M. M., Van Der Worp, H., Wessels, N. J., Dekker, J. H., Slieker-Ten Hove, M. C. P., Berger, M. Y., Vermeulen, K. M., & Blanker, M. H. (2022). Cost-effectiveness of an app-based treatment for urinary incontinence in comparison with care-as-usual in Dutch general practice: a pragmatic randomised controlled trial over 12 months. BJOG : An International Journal of Obstetrics and Gynaecology, 129(9), 1538-1545. https://doi.org/10.1111/1471-0528.17191

@article{cf410b2ccd1d40479f852f0236af9a24,

title = "Cost-effectiveness of an app-based treatment for urinary incontinence in comparison with care-as-usual in Dutch general practice: a pragmatic randomised controlled trial over 12 months",

abstract = "OBJECTIVE: To assess the cost-effectiveness of app-based treatment for female stress, urgency, or mixed urinary incontinence (UI) compared to care-as-usual in Dutch primary care.DESIGN: A pragmatic, randomised controlled, superiority trial.SETTING: Primary care in the Netherlands from 2015 to 2018, follow-up at 12 months.POPULATION: Women with ≥2 UI-episodes per week, access to mobile apps, wanting treatment.INTERVENTIONS: The standalone app included conservative management for UI with motivation aids (e.g., reminders). Care-as-usual delivered according to the Dutch GP guideline for UI.MAIN OUTCOME MEASURES: Costs and cost-effectiveness and -utility were assessed from a societal perspective, based on Incontinence Impact Adjusted Life Years (IIALYs), Quality Adjusted Life years (QALYs) and medical, non-medical and productivity costs. Information on costs was obtained with the iMCQ and iPCQ questionnaires (Medical Consumption and Productivity Cost Questionnaires).RESULTS: 262 women randomised equally to app or care-as-usual; 89 (68%) and 83 (63%) attended follow-up. Costs were lower for app-based treatment with €-161 (95%CI: -180 to -151) per year. Cost-effectiveness showed small mean differences in effect for IIALY (0.04) and QALY (-0.03) and thus larger ICER (-€3,696) and ICUR (€6,379) (Incremental Cost-Effectiveness and Cost-utility Ratios).CONCLUSION: App-based treatment is a cost-effective alternative to care-as-usual for women with UI in Dutch primary care.",

keywords = "app, cost-effectiveness, eHealth, general practice, long-term, pragmatic, primary care, self-management, urinary incontinence, INTERNET-BASED TREATMENT, WOMEN",

author = "Loohuis, {Anne M M} and {Van Der Worp}, Henk and Wessels, {Nienke J} and Dekker, {Janny H} and {Slieker-Ten Hove}, {Marijke C Ph} and Berger, {Marjolein Y} and Vermeulen, {Karin M} and Blanker, {Marco H}",

year = "2022",

month = aug,

doi = "10.1111/1471-0528.17191",

language = "English",

volume = "129",

pages = "1538--1545",

journal = "BJOG : An International Journal of Obstetrics and Gynaecology",

issn = "1471-0528",

publisher = "Wiley",

number = "9",

}

Loohuis, AMM , Van Der Worp, H , Wessels, NJ , Dekker, JH, Slieker-Ten Hove, MCP, Berger, MY , Vermeulen, KM & Blanker, MH 2022, 'Cost-effectiveness of an app-based treatment for urinary incontinence in comparison with care-as-usual in Dutch general practice: a pragmatic randomised controlled trial over 12 months', BJOG : An International Journal of Obstetrics and Gynaecology, vol. 129, no. 9, pp. 1538-1545. https://doi.org/10.1111/1471-0528.17191

Cost-effectiveness of an app-based treatment for urinary incontinence in comparison with care-as-usual in Dutch general practice: a pragmatic randomised controlled trial over 12 months. / Loohuis, Anne M M ; Van Der Worp, Henk ; Wessels, Nienke J et al.
In: BJOG : An International Journal of Obstetrics and Gynaecology, Vol. 129, No. 9, 08.2022, p. 1538-1545.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Cost-effectiveness of an app-based treatment for urinary incontinence in comparison with care-as-usual in Dutch general practice

T2 - a pragmatic randomised controlled trial over 12 months

AU - Loohuis, Anne M M

AU - Van Der Worp, Henk

AU - Wessels, Nienke J

AU - Dekker, Janny H

AU - Slieker-Ten Hove, Marijke C Ph

AU - Berger, Marjolein Y

AU - Vermeulen, Karin M

AU - Blanker, Marco H

PY - 2022/8

Y1 - 2022/8

N2 - OBJECTIVE: To assess the cost-effectiveness of app-based treatment for female stress, urgency, or mixed urinary incontinence (UI) compared to care-as-usual in Dutch primary care.DESIGN: A pragmatic, randomised controlled, superiority trial.SETTING: Primary care in the Netherlands from 2015 to 2018, follow-up at 12 months.POPULATION: Women with ≥2 UI-episodes per week, access to mobile apps, wanting treatment.INTERVENTIONS: The standalone app included conservative management for UI with motivation aids (e.g., reminders). Care-as-usual delivered according to the Dutch GP guideline for UI.MAIN OUTCOME MEASURES: Costs and cost-effectiveness and -utility were assessed from a societal perspective, based on Incontinence Impact Adjusted Life Years (IIALYs), Quality Adjusted Life years (QALYs) and medical, non-medical and productivity costs. Information on costs was obtained with the iMCQ and iPCQ questionnaires (Medical Consumption and Productivity Cost Questionnaires).RESULTS: 262 women randomised equally to app or care-as-usual; 89 (68%) and 83 (63%) attended follow-up. Costs were lower for app-based treatment with €-161 (95%CI: -180 to -151) per year. Cost-effectiveness showed small mean differences in effect for IIALY (0.04) and QALY (-0.03) and thus larger ICER (-€3,696) and ICUR (€6,379) (Incremental Cost-Effectiveness and Cost-utility Ratios).CONCLUSION: App-based treatment is a cost-effective alternative to care-as-usual for women with UI in Dutch primary care.

AB - OBJECTIVE: To assess the cost-effectiveness of app-based treatment for female stress, urgency, or mixed urinary incontinence (UI) compared to care-as-usual in Dutch primary care.DESIGN: A pragmatic, randomised controlled, superiority trial.SETTING: Primary care in the Netherlands from 2015 to 2018, follow-up at 12 months.POPULATION: Women with ≥2 UI-episodes per week, access to mobile apps, wanting treatment.INTERVENTIONS: The standalone app included conservative management for UI with motivation aids (e.g., reminders). Care-as-usual delivered according to the Dutch GP guideline for UI.MAIN OUTCOME MEASURES: Costs and cost-effectiveness and -utility were assessed from a societal perspective, based on Incontinence Impact Adjusted Life Years (IIALYs), Quality Adjusted Life years (QALYs) and medical, non-medical and productivity costs. Information on costs was obtained with the iMCQ and iPCQ questionnaires (Medical Consumption and Productivity Cost Questionnaires).RESULTS: 262 women randomised equally to app or care-as-usual; 89 (68%) and 83 (63%) attended follow-up. Costs were lower for app-based treatment with €-161 (95%CI: -180 to -151) per year. Cost-effectiveness showed small mean differences in effect for IIALY (0.04) and QALY (-0.03) and thus larger ICER (-€3,696) and ICUR (€6,379) (Incremental Cost-Effectiveness and Cost-utility Ratios).CONCLUSION: App-based treatment is a cost-effective alternative to care-as-usual for women with UI in Dutch primary care.

KW - app

KW - cost-effectiveness

KW - eHealth

KW - general practice

KW - long-term

KW - pragmatic

KW - primary care

KW - self-management

KW - urinary incontinence

KW - INTERNET-BASED TREATMENT

KW - WOMEN

U2 - 10.1111/1471-0528.17191

DO - 10.1111/1471-0528.17191

M3 - Article

C2 - 35460163

SN - 1471-0528

VL - 129

SP - 1538

EP - 1545

JO - BJOG : An International Journal of Obstetrics and Gynaecology

JF - BJOG : An International Journal of Obstetrics and Gynaecology

IS - 9

ER -

Loohuis AMM , Van Der Worp H , Wessels NJ , Dekker JH, Slieker-Ten Hove MCP, Berger MY et al. Cost-effectiveness of an app-based treatment for urinary incontinence in comparison with care-as-usual in Dutch general practice: a pragmatic randomised controlled trial over 12 months. BJOG : An International Journal of Obstetrics and Gynaecology. 2022 Aug;129(9):1538-1545. Epub 2022 May 31. doi: 10.1111/1471-0528.17191

Cost-effectiveness of an app-based treatment for urinary incontinence in comparison with care-as-usual in Dutch general practice: a pragmatic randomised controlled trial over 12 months

Abstract

Keywords

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Prizes

Top Publication award, BJOG one year cost-effectiveness

Cite this