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 journalArticleAcademicpeer-review

5 Citations (Scopus)
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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 languageEnglish
Pages (from-to)1538-1545
Number of pages8
JournalBJOG : An International Journal of Obstetrics and Gynaecology
Volume129
Issue number9
Early online date31-May-2022
DOIs
Publication statusPublished - 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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