TY  - JOUR
AU  - Sjöström, Malin
AU  - Lindholm, Lars
AU  - Samuelsson, Eva
PY  - 2017
DA  - 2017/05/08
TI  - Mobile App for Treatment of Stress Urinary Incontinence: A Cost-Effectiveness Analysis
JO  - J Med Internet Res
SP  - e154
VL  - 19
IS  - 5
KW  - mobile application
KW  - pelvic floor
KW  - urinary incontinence, stress
KW  - self care
KW  - cost-benefit analysis
AB  - Background: Mobile apps can increase access to care, facilitate self-management, and improve adherence to treatment. Stress urinary incontinence (SUI) affects 10-35% of women and, currently, an app with instructions for pelvic floor muscle training (PFMT) is available as first-line treatment. A previous randomized controlled study demonstrated that the app benefitted symptom severity and quality of life (QoL); in this study we investigate the cost-effectiveness of the app. Objective: The objective of this study was to evaluate the health economy of the app for treating SUI. Methods: This deterministic cost-utility analysis, with a 1-year societal perspective, compared the app treatment with no treatment. Health economic data were collected alongside a randomized controlled trial performed in Sweden from March 2013 to October 2014. This study included 123 community-dwelling women participants of 18 years and above, with stress urinary incontinence ≥1 time per week. Participants were self-assessed with validated questionnaires and 2-day leakage diaries, and then randomized to 3 months of treatment (app group, n=62) or no treatment (controls, n=61). The app focused on pelvic floor muscle training, prescribed 3 times daily. We continuously registered treatment delivery costs. Data were collected on each participant’s training time, incontinence aids, and laundry at baseline and at a 3-month follow-up. We measured quality of life with the International Consultation on Incontinence Modular Questionnaire on Lower Urinary Tract Symptoms and Quality of Life, and calculated the quality-adjusted life years (QALYs) gained. Data from the 3-month follow-up were extrapolated to 1 year for the calculations. Our main outcome was the incremental cost-effectiveness ratios compared between app and control groups. One-way and multiway sensitivity analyses were performed. Results: The mean age of participants was 44.7 years (SD 9.4). Annual costs were €547.0 for the app group and €482.4 for the control group. Annual gains in quality-adjusted life years for app and control groups were 0.0101 and 0.0016, respectively. Compared with controls, the extra cost per quality-adjusted life year for the app group ranged from −€2425.7 to €14,870.6, which indicated greater gains in quality-adjusted life years at similar or slightly higher cost. Conclusions: The app for treating stress urinary incontinence is a new, cost-effective, first-line treatment with potential for increasing access to care in a sustainable way for this patient group. 
SN  - 1438-8871
UR  - http://www.jmir.org/2017/5/e154/
UR  - https://doi.org/10.2196/jmir.7383
UR  - http://www.ncbi.nlm.nih.gov/pubmed/28483745
DO  - 10.2196/jmir.7383
ID  - info:doi/10.2196/jmir.7383
ER  -