A Randomized Controlled Trial of a Web-Based Management Support System for Children With Urinary Incontinence: The eADVICE Trial

被引:4
作者
Caldwell, Patrina H. Y. [1 ,2 ,8 ]
Richards, Deborah [3 ]
Hamilton, Sana [1 ]
Von Huben, Amy [4 ,5 ]
Teixeira-Pinto, Armando [4 ]
Howell, Martin [4 ,5 ]
Howard, Kirsten [4 ,5 ]
Craig, Jonathan C. [6 ]
Seton, Chris [1 ]
Waters, Karen [1 ,2 ]
Deshpande, Aniruddh [1 ,2 ,7 ]
Scott, Karen M. [2 ]
机构
[1] Childrens Hosp Westmead, Sydney, Australia
[2] Univ Sydney, Discipline Child & Adolescent Hlth, Sydney, Australia
[3] Macquarie Univ, Sch Comp, Sydney, Australia
[4] Univ Sydney, Sch Publ Hlth, Sydney, Australia
[5] Univ Sydney, Menzies Ctr Hlth Policy & Econ, Sydney, Australia
[6] Flinders Univ S Australia, Coll Med & Publ Hlth, Adelaide, Australia
[7] Univ Newcastle, Sch Med & Publ Hlth, Newcastle, Australia
[8] Univ Sydney, Childrens Hosp Westmead, Clin Sch, Locked Bag 4001, Westmead, NSW 2145, Australia
关键词
enuresis; urinary incontinence; children; telemedicine; outpatient clinic; HEALTH LITERACY; ENURESIS; STANDARDIZATION; ADOLESCENTS; CARE;
D O I
10.1097/JU.0000000000003832
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose:Children referred to specialist outpatient clinics by primary care providers often have long waiting times before being seen. We assessed whether an individualized, web-based, evidence-informed management support for children with urinary incontinence while waiting reduced requests for specialist appointments.Materials and Methods:A multicenter, waitlisted randomized controlled trial was conducted for children (5-18 years) with urinary incontinence referred to tertiary pediatric continence clinics. Participants were randomized to the web-based eHealth program electronic Advice and Diagnosis Via the Internet following Computerized Evaluation (eADVICE), which used an embodied conversational agent to engage with the child at the time of referral (intervention) or 6 months later (control). The primary outcome was the proportion of participants requesting a clinic appointment at 6 months. Secondary outcomes included persistent incontinence, and the Paediatric incontinence Questionnaire (PinQ) score.Results:From 2018 to 2020, 239 children enrolled, with 120 randomized to eADVICE and 119 to the control arm. At baseline, participants' mean age was 8.8 years (SD 2.2), 62% were males, mean PinQ score was 5.3 (SD 2.2), 36% had daytime incontinence, and 97% had nocturnal enuresis. At 6 months, 78% of eADVICE participants vs 84% of controls requested a clinic visit (relative risk 0.92, 95% CI 0.79, 1.06, P = .3), and 23% eADVICE participants vs 10% controls were completely dry (relative risk 2.23, 95% CI 1.10, 4.50, P = .03). The adjusted mean PinQ score was 3.5 for eADVICE and 3.9 for controls (MD -0.37, 95% CI -0.71, -0.03, P = .03).Conclusions:The eADVICE eHealth program for children awaiting specialist appointments doubled the proportion who were dry at 6 months and improved quality of life but did not reduce clinic appointment requests.
引用
收藏
页码:364 / 375
页数:12
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