Overactive bladder is a common condition that affects 20% of females, and substantially impairs quality of life. Despite this, adherence to treatment regimens (e.g., medication and behavioural modification) remains low. For this reason, researchers from Massachusetts General Hospital, Boston, Massachusetts, USA, investigated whether an asynchronous telehealth programme could keep patients engaged in care and expedite therapy options.
Twenty-three females who had been newly diagnosed with overactive bladder during in an in-person outpatient appointment at Massachusetts General Hospital were enrolled in the pilot study. Rather than scheduling a traditional clinic follow-up visit at 3 months, the females instead received an asynchronous visit approximately 1 month after their initial office consultation. This comprised an electronic questionnaire asking patients about their symptoms and treatment progress. Based on an individual’s response, a practitioner then provided specific guidance.
First author Marcus Ortega explained: “The clinician might recommend switching to a different medication because of side effects or lack of efficacy, or reinforce certain behaviors to improve symptoms.” Ortega continued: “The patient’s answers on the validated medical questionnaires also allow us to objectively compare over time whether symptoms are improving, since it can be difficult for patients to keep track of subjective symptoms month after month.”
In total, 50 e-visits were completed. Between the first asynchronous visit and the last, there was a statistically significant improvement in urinary symptoms, as well as a decrease in the number of incontinence episodes. Furthermore, over 30% of study participants switched medication or had the dosage adjusted. A reduction in fluid intake, including caffeinated and carbonated beverages, was also observed. Importantly, study participants rated the experience an 8.8 on a 10-point satisfaction scale, indicating that they were very pleased with the experience.
Improvements in the patients’ urinary symptoms were attributed to more frequent engagement with clinicians, ultimately leading to enhanced compliance in medication use and behavioural change. Asynchronous visits offer a number of additional advantages, such as reducing unnecessary medical visits and breaking down geographical barriers to healthcare. Moreover, asynchronous telehealth visits may accelerate the time for individuals to receive Botox injections, sacral neuromodulation, tibial nerve stimulation, and other advanced therapies.
Going forward, randomised trials are necessary to confirm the efficacy of asynchronous visits. “We hope this platform will become more widely available for other medical conditions,” summarised Ortega.
