Development of an online personalized self-management intervention for men with uncomplicated LUTS

Marco H Blanker, Pim Brandenbarg, Bart G C Slijkhuis, Martijn G Steffens, Michael R van Balken, Petra Jellema, Marco H Blanker, Pim Brandenbarg, Bart G C Slijkhuis, Martijn G Steffens, Michael R van Balken, Petra Jellema

Abstract

Aims: To develop an online platform to facilitate evidence-based self-management of lower urinary tract symptoms (LUTS) in men.

Methods: Using the PubMed database (search until January 2017) and relevant guidelines, we reviewed evidence for the self-management of LUTS and identified suitable components for the intervention. Next, we built an algorithm that provided individualized advice based on patient characteristics and symptoms for use on an online platform. Men with LUTS tested the usability of the intervention and provided feedback. Finally, we surveyed urologists and general practitioners to identify potential areas for improvement of the intervention.

Results: We identified nine self-help interventions from 48 eligible publications. These were as follows: information and education about LUTS, pelvic floor muscle training, bladder training, urethral milking, double voiding, caffeine management, alcohol management, fluid management, and exercise advice. The level of evidence for each item was low due to the paucity of research available. Six men with LUTS reported difficulties understanding and completing the frequency-volume chart online. The 158 surveyed physicians agreed (≥50% positive ratings) on the inclusion of seven advice items, but not for double voiding and fluid management. Respondents noted that some advice should be provided to all men with LUTS, while other advice should only be presented to certain groups. Some recommendations for additions were offered.

Conclusions: Despite a lack of evidence for the self-management advice, physicians agreed with most of the included advice. The online platform needs further development. Therefore, adjustments will be made and we will assess its impact in future studies.

Keywords: eHealth; lower urinary tract symptoms; online intervention; self-management.

Conflict of interest statement

The authors declare that they have no conflict of interests.

© 2019 The Authors. Neurourology and Urodynamics Published by Wiley Periodicals, Inc.

Figures

Figure 1
Figure 1
Physician responses to whether each advice item should be included in the self‐management intervention. Data from 70 GPs and 88 urologists were included for the information and education advice, from 69 GPs and 82 urologists for the PFMT advice, and from 63 GPs and 73 urologists for all other items. GP, general practitioner (including trainees); PFMT, pelvic floor muscle therapy; URO, urologist (including trainees)

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Source: PubMed

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