Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Profundum Institute, Education and Research, Dordrecht, The Netherlands.
BJOG. 2022 Aug;129(9):1538-1545. doi: 10.1111/1471-0528.17191. Epub 2022 May 31.
To assess the cost-effectiveness of app-based treatment for female stress, urgency or mixed urinary incontinence (UI) compared with care-as-usual in Dutch primary care.
A pragmatic, randomised controlled, superiority trial.
Primary care in the Netherlands from 2015 to 2018, follow-up at 12 months.
Women with ≥2 UI-episodes per week, access to mobile apps, wanting treatment.
The standalone app included conservative management for UI with motivation aids (e.g. reminders). Care-as-usual delivered according to the Dutch GP guideline for UI.
Costs and cost-effectiveness and -utility were assessed from a societal perspective, based on incontinence impact adjusted life years (IIALYs), quality adjusted life years (QALYs) and medical, non-medical and productivity costs. Information on costs was obtained with the iMCQ and iPCQ questionnaires (medical consumption and productivity cost questionnaires).
In all, 262 women were andomised equally to app or care-as-usual; 89 (68%) and 83 (63%) attended follow-up, respectively. Costs were lower for app-based treatment with € -161 (95% confidence interval [CI -180 to -151) per year. Cost-effectiveness showed small mean differences in effect for IIALY (0.04) and QALY (-0.03) and thus larger incremental cost-effectiveness ratios (ICER: -€3696) and incremental cost-utility ratios (ICUR: €6379).
App-based treatment is a cost-effective alternative to care-as-usual for women with UI in Dutch primary care.
App-treatment for female urinary incontinence cost-effective compared to care-as-usual in general practice after 12 months.
评估基于应用程序的治疗女性压力性、紧迫性或混合性尿失禁（UI）与荷兰初级保健中的常规护理相比的成本效益。
一项实用的、随机对照的优效性试验。
2015 年至 2018 年荷兰的初级保健，12 个月时进行随访。
每周有≥2 次 UI 发作、可使用移动应用程序、有治疗意愿的女性。
独立应用程序包括使用动机辅助措施（例如提醒）进行 UI 的保守管理。根据荷兰全科医生 UI 指南提供常规护理。
基于失禁影响调整后的生命年（IIALYs）、质量调整生命年（QALYs）以及医疗、非医疗和生产力成本，从社会角度评估成本和成本效益/效用。通过 iMCQ 和 iPCQ 问卷（医疗消费和生产力成本问卷）获得成本信息。
共有 262 名女性被随机等分为应用程序组和常规护理组；分别有 89 名（68%）和 83 名（63%）参加了随访。应用程序治疗的成本较低，每年节省 161 欧元（95%置信区间[CI]：-180 至-151）。成本效益显示 IIALY（0.04）和 QALY（-0.03）的效果差异较小，因此增量成本效益比（ICER：-3696 欧元）和增量成本效用比（ICUR：6379 欧元）更大。
在荷兰初级保健中，与常规护理相比，基于应用程序的治疗是治疗女性 UI 的一种具有成本效益的选择。
