JMIR Publications

ABSTRACT

Background:

Overactive bladder (OAB) is a prevalent condition that substantially impairs quality of life, yet the real-world utility of standard behavioral and pharmacological therapies is often limited by poor long-term adherence. Digital interventions have emerged as a promising strategy to provide accessible and personalized support, but their overall efficacy compared with conventional care remains to be systematically established.

Objective:

To evaluate the efficacy of digital interventions compared with conventional care for improving symptoms, quality of life (QoL), and treatment adherence in patients with OAB.

Methods:

A systematic review and meta-analysis was conducted using data from PubMed, EMBASE, the Cochrane Library, and other databases from inception to July 2025. Randomized controlled trials (RCTs) assessing technology-based digital interventions for adult patients with OAB were included. The primary outcomes were objective symptom improvement (measured by bladder diaries) and subjective symptom scores, while secondary outcomes included QoL and attrition rates. Data were pooled using a random-effects model, and subgroup analyses were performed based on intervention delivery mode (automated content, telemedicine, or supervised telerehabilitation) and duration.

Results:

Seven RCTs involving 544 participants were included. Digital interventions were associated with a significant improvement in overall objective symptom indicators compared with conventional care (MD = -1.72, 95% CI [-2.61, -0.83]), specifically reducing 24-hour urinary frequency (MD = -2.55) and urge incontinence episodes (MD = -2.07). Although the pooled analysis of subjective symptom scores showed a non-significant trend toward improvement (SMD = -1.07), subgroup analysis revealed that supervised telerehabilitation yielded the largest effect (SMD = -2.51), and interventions lasting 6 to 13 weeks were associated with significant symptom reduction (SMD = -1.41). Furthermore, digital interventions significantly improved QoL (SMD = 1.47, 95% CI [0.11, 2.84]). No significant difference was observed in dropout rates between digital and conventional care groups (RR = 0.92).

Conclusions:

Digital interventions are a practical and effective approach for OAB management, significantly improving patients' objective symptoms and quality of life without increasing attrition rates. Supervised telerehabilitation showed the greatest potential for symptom reduction, and a 6-to-13-week duration was identified as the optimal therapeutic window. These findings support a stepped-care model, leveraging high-intensity digital interventions for initial treatment followed by scalable tools for maintenance to enhance patient outcomes. Clinical Trial: PROSPERO International Prospective Register of Systematic Reviews CRD420251164488; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251164488