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Cost effective self-management of urinary incontinence addressed to women across Europe

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New app empowers women to self-manage urinary incontinence

Urinary incontinence (UI), any involuntary urine leakage, affects 56 million EU citizens at some time in their lives. Now, women can self-manage this chronic disease at home with a new system, WOMEN-UP.

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UI is considered a disease according to the World Health Organization and costs around USD 10 billion in long-term care. It affects all aspects of life, from work to social life. The WOMEN-UP project is a European consortium of eight experts from six countries. “We have developed a cost-effective advanced treatment that empowers women through self-management of this chronic disease,” informs Miquel Angel Mañanas and Juan Ramos, project and scientific coordinators, respectively. The approach is based on pelvic floor muscle training (PFMT). Involving the muscles at the base of the pelvis where training reports a success rate of 70 %, proper PFMT may be difficult. Muscles involved are invisible externally and feedback as to an effective or ineffective workout is not easily available. The main problem is that patients must commit to a regular, periodic training schedule.

Therapy for a serious disease becomes fun and games

“The WOMEN-UP integrated system is based on lifestyle interventions and PFMT, both guided via a smartphone app in connection with a set of biofeedback devices and which also provides remote supervision from a therapist,” Mañanas outlines. Both the devices – a vaginal device and a belt – are wireless and rechargeable. Different games suit varying exercises for each type of pelvic muscle. “The games have been designed taking into account the value of serious gaming in improving treatment outcomes, as evidenced by the study of current gaming approaches, and according to preferences shown by surveys,” explains Mañanas. After the exercise, the patient can see an account of progress and the therapist receives a summary of each patient’s activities colour coded according to progress.

Trials test the efficacy of WOMEN-UP exercise and ladies enrolled in a MOOC

Three European hospitals in Barcelona, Amsterdam and Finland have taken part in a randomised controlled trial. Success at centres in northern, central and southern Europe indicate the device can be used in different cultural contexts and different health systems. More than 260 women, roughly half in the control group and half in the intervention group, took part. Clinical results showed very good patient satisfaction with the WOMEN-UP system and resulted in significant improvements of symptoms and in quality of life. Online, a massive open online course (MOOC) opened its ‘e-doors’ to women who registered online to learn about the basics of UI and its improvement with use of e-health tools.

Overwhelming benefits of the WOMEN-UP system

Benefits of using the WOMEN-UP system include home treatment that is more comfortable for the patient and less stressful but with continuous remote medical supervision. Reetta Lahderine, a therapist at Kuopio University Hospital, Finland, reports: “I can easily make an individual training programme and ensure the right amount of contraction and relaxation will be done.” She further comments on the flexibility: “I can also change the programme without an appointment, useful when the patient lives far from the hospital.” In constant interaction with her therapist as she follows the programme, it is much more improbable that the patient will give up. Financial savings for all concerned, from patient to healthcare authorities, are substantial. Costs are reduced by fewer visits to clinics, less treatment, indirect loss of earnings by absence from work and, significantly, not having to use incontinence pads used by the majority of women who don’t seek care.

Keywords

WOMEN-UP, women, disease, treatment, home, urinary incontinence, self-management, PFMT, e-health

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