To assess the cost-effectiveness of app-based treatment for female stress, urgency, or mixed urinary incontinence (UI) compared to 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).
262 women randomised equally to app or care-as-usual; 89 (68%) and 83 (63%) attended follow-up. Costs were lower for app-based treatment with €-161 (95%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 ICER (-€3,696) and ICUR (€6,379) (Incremental Cost-Effectiveness and Cost-utility Ratios).
App-based treatment is a cost-effective alternative to care-as-usual for women with UI in Dutch primary care.
BJOG : an international journal of obstetrics and gynaecology. 2022 Apr 23 [Epub ahead of print]
Anne M M Loohuis, Henk Van Der Worp, Nienke J Wessels, Janny H Dekker, Marijke C Ph Slieker-Ten Hove, Marjolein Y Berger, Karin M Vermeulen, Marco H Blanker
University of Groningen, University Medical Centre Groningen, Department of General Practice and Elderly Care medicine, FA21, PO, Groningen, The Netherlands., Profundum Institute, Education and Research, van Godewijckstraat 104a, GX, Dordrecht, The Netherlands., University of Groningen, University Medical Centre Groningen, Department of Epidemiology, FA21, PO, Groningen, The Netherlands.