Care provider views on app-based treatment for female urinary incontinence: a mixed-methods study.

Abstract

App-based treatment for female urinary incontinence (UI) is a cost-effective alternative to care as usual. For successful implementation it is of major importance to involve stakeholders like care providers. To explore the views and preferences of care providers on app use for the treatment of UI and to identify the anticipated barriers to, and facilitators of, implementation. We performed an exploratory, two-phase, sequential mixed-methods study. In phase 1, the views of care providers were explored through five focus group sessions with care providers involved in UI: GPs, practice assistants (PAs), pelvic physical therapists (PPTs), and (uro)gynecologists (UGs). In phase 2, the identified themes and subthemes were quantified in an online survey distributed among different care providers matching these groups. In the focus group sessions, 30 female and two male care providers participated. Survey participants included 351 PAs and 76 PPTs (all female) next to 124 GPs and 183 UGs (70% female). Caregivers generally considered UI treatment apps as having a supportive role, being less convinced about their advantages in the absence of a care provider. Additionally, they required that the effectiveness of an app should be proven first, and that privacy and safety should be ensured. Contrasting with other research, lack of time and financial compensation were not considered important barriers to implementation. Our results add to the existing knowledge about eHealth-related barriers and facilitators. These findings can be used to optimise implementation strategies for other apps and to enhance the uptake of app-based treatment for UI in the Netherlands.