The Effect of the TENA SmartCare Change Indicator on Care Efficiency and Skin Health in Long Term Care Facilities

A Post-market Cluster Randomized Controlled Trial of the Effect of the TENA SmartCare Change Indicator on Continence Care Efficiency and Skin Health in Long Term Care Facilities

The purpose of this post market clinical investigation is to demonstrate the performance and safety of the TENA SmartCare Change Indicator when used in a nursing home setting.

Study Overview

• Status: Completed
• Conditions: Urinary Incontinence
• Intervention / Treatment: Device: TENA SmartCare Change Indicator

Detailed Description

The TENA SmartCare Change Indicator is intended for use on individuals suffering from Urinary Incontinence who are cared for in a nursing home environment, by one or more professional caregivers. The TENA SmartCare Change Indicator is an accessory to TENA absorbing incontinence products. This clinical investigation is intended to demonstrate that use of TENA SmartCare Change Indicator has the ability to increase continence care efficiency at the nursing home by reducing the time needed in daily handling of absorbing incontinence products. Furthermore, this reduction in needed care does not have a detrimental effect on skin health. Secondarily, the investigation have multiple outcomes regarding number of checks, changes and leaks and also quality of life for subjects and qualitative measures for caregivers. Furthermore, the safety will continuously be monitored through analyzing device-related adverse events reported during the investigation.

• Study Type: Interventional
• Enrollment (Actual): 108
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Alberta
    • Edmonton, Alberta, Canada, T6G 2P4
      • University of Alberta
• Germany
  • Krefeld, Germany, 47805
    • Hochschule Niederrhein University of Applied Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Subject has urinary incontinence managed with incontinence products with tapes, belted or pull up incontinence product type (products for moderate to heavy incontinence).
2. Subject is a permanent (intended length of stay four months or longer) resident of the nursing home.
3. Subject is unable to consistently communicate toileting needs.
4. Subject is unable to successfully toilet and change the pad without assistance.
5. Subject is using or is willing to use TENA Slip (Stretch) TENA Flex (Belted) and TENA Pants (Underwear) absorbing products for the study.
6. Subject has a waist size appropriate to the available sizes of incontinence products.
7. Subject is willing and able to provide informed consent to participate or if unable to provide consent have a legal representative who is willing and able to provide informed consent on behalf of the subject.
8. Subject is part of a continence care regimen, defined as "check and change", using any method.
9. If applicable, subject is to be on a stable regimen of medications for urinary incontinence
10. Subject is over 18 years of age.

Exclusion Criteria:

1. Subject has frequent (daily) faecal incontinence in the pad or having severe problems with faecal incontinence as determined by the investigator.
2. Subject has severe incontinence product related skin problems, as defined by the GLOBIAD categorization 2B (skin loss & infection).
3. Subject has any type of indwelling or external urinary catheter(s).
4. Subject is anuric.
5. Subject is managed using another automated or digital health technology incontinence management device.
6. Subject has responsive behaviors of sufficient severity, in the opinion of the care staff, to make participation impractical.
7. Subject has any other condition that makes participation in the clinical investigation inappropriate, as judged by investigator.
8. Subject has a life expectancy of fewer than 3 months or be receiving palliative or terminal care.
9. Subject has participated in an investigational study of a drug, biologic, or device within 30 days prior to entering the clinical investigation or planned during the clinical investigation.
10. Subject is dependent on either alcohol or recreational drugs.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Device; Clusters in this arm will start using the device and use it for 6 weeks.	Device: TENA SmartCare Change Indicator; The intervention is a medical device system that consists of a reusable electronic sensor and an application installed on one or more smart phones. The device estimates the saturation level of an absorbing incontinence product used by a study subject. The device is non-invasive and does not have any effect on the function of the absorbing incontinence product.
No Intervention: Control; Clusters in this arm will not receive the device it will continue with usual care with no changes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Care Efficiency score	Care efficiency is the weighted sum of the pre-defined care events divided by the number of recorded diary days of the subject in question. The last week of the 4 week baseline and last week of the 6 week intervention/control time period is to be compared. Data is presented as average daily care efficiency score (min/day). Data is collected daily via the study diary.	10 weeks.
Daily Skin Health score	Skin health score is based on skin health grades (from 0, no skin problems to 4, very seveer skin problems) that have been reported by the caregiver in the study diary. The last week of the 4 week baseline and last week of the 6 week intervention/control time period is to be compared. Data is presented as average daily skin health score.	10 weeks.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Skin health score	Measured by the skin health assessment tool at study completion visit and compared to the end of baseline visit.	10 weeks.
Quality of life and level of utility	Measured using the EQ-5D-5L questionnaire at study completion visit and compared to the end of baseline visit.	10 weeks.
Quality of life according to the QoL-AD	Measured and scored at completion visit and compared to the end of baseline visit.	10 weeks.
Level of agitation and responsive behavior.	Measured via interRAI Aggressive Behavior Scale at study completion visit and compared to the end of baseline visit.	10 weeks.
Total absorption value	From the study diary the type, number and absorption value of the incontinence care product is retrieved. This data is used to create a total absorption measure. The last week of the 4 week baseline and last week of the 6 week intervention/control time period is to be compared.	10 weeks.
Caregiver work engagement	Using the UWES questionnaire the work engagement of caregivers are measured at a cluster's end-of-trial visit and compared to the end of baseline visit.	10 weeks.
Caregiver work conditions	Measured using the organizational headroom questionnaire at a cluster's end-of-trial visit and compared to the end of baseline visit.	10 weeks.
Qualitative data on implementation, uptake, opportunities and barriers to use.	Response to interviews with caregivers, coded by the investigator and collated into trends and themes. Conducted after completion of study for subjects.	10 weeks.
Safety data for the device.	Incidence of adverse events (AE), adverse device effects (ADE), serious adverse events (SAE), serious adverse device effects (SADE), and device deficiency (DD).	10 weeks.
Number of continence care product checks	From the study diary the number of checks of absorbing incontinence products is retrieved. The last week of the 4 week baseline and last week of the 6 week intervention/control time period is to be compared. Data is presented as average daily number of checks.	10 weeks.
Number of continence care product changes	From the study diary the number of changes of absorbing incontinence products is retrieved. The last week of the 4 week baseline and last week of the 6 week intervention/control time period is to be compared. Data is presented as average daily number of changes.	10 weeks.
Number of continence care toilet visits	From the study diary the number of toilet visits is retrieved. The last week of the 4 week baseline and last week of the 6 week intervention/control time period is to be compared. Data is presented as average daily number of toilet visits.	10 weeks.
Number of continence care clothing changes	From the study diary the number of clothing changes due to leakages is retrieved. The last week of the 4 week baseline and last week of the 6 week intervention/control time period is to be compared. Data is presented as average daily number of clothing changes.	10 weeks.
Number of continence care bed linen changes	From the study diary the number of bed linen changes due to leakages is retrieved. The last week of the 4 week baseline and last week of the 6 week intervention/control time period is to be compared. Data is presented as average daily number of linen changes.	10 weeks.
The time spent on continence care episodes	From the study diary the total time spent on continence care is retrieved. The last week of the 4 week baseline and last week of the 6 week intervention/control time period is to be compared. Data is presented as average daily time spent on continence care.	10 weeks.
Number of sleep interruptions due to continence care	From the study diary the number of sleep interruptions are retrieved. The last week of the 4 week baseline and last week of the 6 week intervention/control time period is to be compared. Data is presented as average daily number of interruptions.	10 weeks.
Time spent in a saturated continence care product	Data from study diary used to retrieve the total hours that occur between an observed fully saturated product and the change of the saturated product. The last week of the 4 week baseline and last week of the 6 week intervention/control time period is to be compared. Data is presented as average daily time spent in the saturated product.	10 weeks
Number of unnecessary checks.	Data from study diary used to retrieve the number of unnecessary checks/changes. An unnecessary check/change is defined as, an activity line where a product check was performed but no product change occurred or an activity line where a product change occurred but neither a fully nor partially saturated product was indicated. The last week of the 4 week baseline and last week of the 6 week intervention/control time period is to be compared. Data is presented as average daily number of checks/changes.	10 weeks

Collaborators and Investigators

• Sponsor: Essity Hygiene and Health AB
• Investigators: Principal Investigator: Adrian Wagg, MD, University of Alberta

Study record dates

Study Major Dates

• Study Start (Actual): October 7, 2022
• Primary Completion (Actual): December 15, 2023
• Study Completion (Actual): January 30, 2024

Study Registration Dates

• First Submitted: February 9, 2022
• First Submitted That Met QC Criteria: February 9, 2022
• First Posted (Actual): February 18, 2022

Study Record Updates

• Last Update Posted (Actual): August 11, 2025
• Last Update Submitted That Met QC Criteria: August 5, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Urogenital Diseases; Male Urogenital Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urination Disorders; Lower Urinary Tract Symptoms; Urological Manifestations; Urinary Incontinence
• Other Study ID Numbers: WHEELS-ONE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No