JMIR Publications

ABSTRACT

Background:

Stress urinary incontinence (SUI) is a common problem with a great potential influence on quality of life. Although SUI can be treated effectively with pelvic floor muscle training (PFMT), only a minority of women with this complaint seek help. An Internet-based, eHealth, intervention could make care more accessible. The Swedish eHealth intervention Tät®-treatment of Stress Urinary Incontinence offers PFMT and has shown to be effective in reducing symptoms of women with SUI. This intervention might be helpful for Dutch women too, but its adoption needs to be studied as the Netherlands differs from Sweden in terms of geographical characteristics and healthcare organization.

Objective:

We will use this protocol to investigate the barriers and facilitators to the adoption of an eHealth intervention for Dutch women with SUI and the effects of this intervention.

Methods:

We conduct a mixed-method study among 800 Dutch women with SUI who participate in the translated version of Tät®-treatment of Stress Urinary Incontinence. This eHealth intervention takes three months. A pre-post study is conducted using surveys, which are sent at baseline (T0), three weeks after baseline (T1), post-treatment (T2), and three months post-treatment (T3). After the intervention, semi-structured interviews will be held with 15-20 participants. The primary outcomes are barriers and facilitators to using the Tät®-treatment of Stress Urinary Incontinence. This will also be analysed between groups that differ in age and severity of incontinence. A thematic content analysis of the qualitative data will be performed. The secondary outcomes are: (1) effect on symptoms of urinary incontinence, (2) effect on quality of life, (3) factors that are potentially associated with success. Effects will be analysed by mixed model analysis. Logistic regression analysis will be used to study what patient-related factors are associated with success.

Results:

Enrolment started in July 2018 and will be finished by December 2019. Data analysis will start in March 2020.

Conclusions:

An eHealth intervention for Dutch women with SUI is promising because it can make treatment more accessible. The strength of this study is that it explores the possibilities for an Internet-based-only treatment for women with SUI by using both quantitative and qualitative research methodologies. The study elaborates on existing results by using a previously tested and effective eHealth programme. Insight into the barriers and facilitators to using this programme can enhance the implementation of the intervention in the Dutch healthcare system. Clinical Trial: Prospectively registered at Netherlands Trial Registry (NTR-6956) in January 2018.