The impact of follow up telephone call on the adherence rate and the therapeutic effect of pelvic floor muscle training program on stress urinary incontinence

Abstract

Background: The prevalence of urinary incontinence (UI) is high and it is associated with substantial physical and psychological morbidity, and large societal costs. Pelvic floor muscle training (PFMT) is recommended as a first-line treatment for stress UI in women. The effect of PFMT on stress UI is influenced by the subjects' adherence to PFMT program. This study aimed to evaluate the impact of weekly follow up telephone call by a physician on the adherence to PFMT program and the therapeutic effect of PFMT on stress UI in women. Methods This study was a quasi-randomized trial. We divide eligible women with stress UI into control group and experimental group alternatively according to the order of enrollment. The subjects in the control group were taught with a routine PFMT program, a video explaining the cause of stress UI and how to perform PFMT, and then were recommended to do home-based PFMT for 8 weeks. Subjects in the experimental group were followed with a weekly telephone call by a physician in addition to routine PFMT program for the control group. All patients were requested to return to out-patient department every 4 weeks. Adherence to PFMT was evaluated with the frequency of performing PFMT. If a subject performed PFMT ＞= 3 days every week, she would be categorized as adherent to PFMT. The therapeutic effect of PFMT was evaluated by a question on the condition of urine leak after 8 weeks of enrollment. If a subject answered urine leakage was cured or was much improved, she would be categorized as a subject with effective therapy. Chi-square test was used to evaluate the difference in adherence rate and therapeutic effect between different groups. Results: There were 50 subjects enrolled for each group. The rate of adherence to PFME for subjects in the experimental group (45/50, 90.0%) was significant higher (X^2=25.6684, p＜0.05) than those in the control group (21/50, 42.0%). The rate of effective therapy for subjects adherent to PFMT (51/66, 77.3%) was significant higher (X^2=26.7939, p＜0.05) than those not adherent to PFMT (8/34, 23.5%). Conclusion: A weekly telephone call by a physician increased the adherence rate of PFMT. Adherence to PFMT improved the therapeutic effect of PFMT for stress UI.