Minimum Important Difference of the ICIQ-UI SF Score after Self-management of Urinary Incontinence via a Freely Available Mobile App

Asklund I1, Nyström E1, Lindam A2, Samuelsson E1

Research Type

Clinical

Abstract Category

E-Health

Abstract 233
Best Conservative Management 1
Scientific Podium Session 16
Friday 9th September 2022
09:50 - 10:05
Hall K1/2
Conservative Treatment Pelvic Floor Stress Urinary Incontinence Urgency Urinary Incontinence Mixed Urinary Incontinence
1. Department of Public Health and Clinical Medicine, Umeå University, Sweden, 2. Unit of Research, Education, and Development, Östersund Hospital, Östersund, Sweden
Online
Presenter
Links

Abstract

Hypothesis / aims of study
To determine clinically relevant improvements after self-management of urinary incontinence with an app that supports pelvic floor muscle training (PFMT) and to evaluate Minimum Important Differences (MIDs) in relation to severity and type of urinary incontinence.
Study design, materials and methods
A secondary analysis of data from a prospective cohort study evaluating the effect of a freely available app that supports pelvic floor muscle training [1]. Adult, non-pregnant, non-postpartum women who aimed to treat their urinary incontinence and had completed the Patient Global Impression of Improvement (PGI-I) at 3-month follow-up, were included. We registered their answers to the International Consultation on Incontinence Questionnaire (ICIQ-UI SF) at baseline and follow-up. The change in score was analysed for correlation (Spearman) and using one-way ANOVA to determine a MID. The MID in general and for each sub-group was set to the mean change of the women who reported being a little better.
Results
In total 1,733 women with all types of urinary incontinence were included. Of those, more than half (54.8%) reported having symptoms of stress urinary incontinence only, 31.7% reported symptoms of mixed urinary incontinence and 10.8% of only urgency urinary incontinence. The mean age was 46.5 years (range 18-87). The mean baseline ICIQ-UI SF score was 8.92 (range 3-21). When divided into severity categories, 354 (20.4%) had a slight severity, 1,059 (61.1%) moderate, 300 (17.3%) severe and 20 (1.2%) very severe. 
There was a significant correlation between the PGI-I and change in ICIQ-UI SF, Spearman rho -0.323 (p<0.001). The one-way ANOVA revealed significant differences between PGI-I categories (p<0.001) and the MID was set to 1.46 (95% Confidence Interval [CI] 1.26-1.67). Sub-group analysis could not determine a MID for the group with slight severity. For moderate severity the MID was set to 1.33 (95% CI 1.10-1.57) and for severe/very severe to 3.59 (95% CI 3.08-4.09). There was no difference in MIDs between different types of incontinence.
Interpretation of results
The results showed that women with a larger reduction in symptom score experienced a greater impression of improvement. For women who seek to self-manage urinary incontinence via eHealth, a reduction of 1.46 points on the ICIQ-UI SF score would be the minimum important difference. For the group with slight incontinence, a MID could not be determined despite the large sample size. For the group with moderate incontinence, 1.33 points was a clinically relevant reduction and for the group with severe incontinence 3.59 points was clinically relevant. We found no differences in MID between the different types of urinary incontinence, but this finding should be interpreted with caution.
Concluding message
The MID for self-management of urinary incontinence via a freely available mobile app was lower than for other types of conservative management. Differences in baseline severity should be taken into account when using a MID to interpret clinical trial results.
References
  1. Rygh P, Asklund I, Samuelsson E. Real-world effectiveness of app-based treatment for urinary incontinence: a cohort study. BMJ Open. 2021;11(1):e040819.
Disclosures
Funding The collection of data and this current study were funded by grants from the Kamprad Family Foundation for Entrepreneurship, Research, and Charity; the VISARE NORR Fund, Northern country councils Regional federation; and Region Jämtland Härjedalen. Clinical Trial No Subjects Human Ethics Committee The collection of data for this study was approved by the Regional Ethical Review Board, Umeå (number 2012-325-31M with amendments number 2014-389-32M, 2016-80-32M, 2017-405-32M and 2020-04898) and the specific analysis conducted in this study was approved by the Swedish Ethical Review Authority (number 2020-04898). Helsinki Yes Informed Consent Yes
Citation

Continence 2S2 (2022) 100322
DOI: 10.1016/j.cont.2022.100322

22/11/2024 15:26:51