JMIR Publications

ABSTRACT

Abstract Introduction: Urinary incontinence (UI) is the most prevalent pelvic floor dysfunction, with incidence increasing with age. Numerous studies have demonstrated the effectiveness of pelvic floor exercises in improving UI and reducing urine leakage. However, access to pelvic floor treatment remains limited due to barriers such as lengthy waiting lists and poor adherence to prescribed exercises. Digital solutions incorporating behaviour change techniques (BCTs) and gamification elements may support self-management of bladder health, particularly for individuals aged 50 and over who may face challenges in accessing conventional treatments.

Methods:

A rapid review was conducted to identify mobile applications and websites integrating BCTs and gamification elements to facilitate bladder health self-management among adults aged 50 and above. The search was initiated in July 2024 and updated in January 2025 across three sources: (1) mobile app stores (Google Play Store and Apple App Store in Spain, Lithuania, and the United Kingdom (UK)) using the keywords "pelvic floor," "urinary incontinence," and "bladder"; (2) websites (the first 80 results in Google for each country); and (3) academic databases (PubMed, Scopus, CINAHL, and Google Scholar) for journal articles, book chapters, and conference papers published in English, Spanish, or Lithuanian. Inclusion criteria required that solutions be independently usable without healthcare supervision, incorporate at least one BCT (e.g., training, education, monitoring, prompting), be evidence-informed (i.e., include participants aged ≥50 years in their design or piloting phase or explicitly target this demographic), and be available in Spain, the UK, or Lithuania. The Mobile App Rating Scale (MARS) was employed to assess app quality, and the taxonomy of 93 BCTs by Michie et al. was used for BCT classification. All review and data extraction processes were conducted in duplicate.

Results:

Twenty-one studies met the inclusion criteria, identifying eight eligible mobile applications and one website. Among the eight apps, only two were available on either Google Play or the Apple App Store. No apps were identified in Lithuania, whereas one was found in Spain and three in the UK. Of these, one UK app was accessible on both Google Play and the Apple App Store, while the others were limited to a single platform. The website search did not identify any scientifically validated platforms across the three countries, except for one website mentioned in a scientific publication.

Conclusions:

There is a limited availability of evidence-based digital solutions for individuals aged 50 and over. Existing applications suggest potential benefits in UI reduction and quality of life improvement; however, further research and development are needed to enhance accessibility and efficacy. Trial registration: The protocol for this review is registered on PROSPERO (Reference: CRD42024597624)