Multidisciplinary self-management telecare system may improve quality o life in patients with interstitial cystitis / bladder pain syndrome (IC/BPS) – A randomized controlled study

Purpose: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic syndrome characterized by bladder pain with irritative lower urinary tract symptoms, such as urinary urgency, frequency, and nocturia. Until now there is no specific treatment demonstrated as sufficient efficacy and evidence-based treatment guideline suggested first-line therapy including patient education, behaviour modification, and stress management should be offered for all patients. Recent studies showed telecare system, especially base on video-tailored, can improve the management of chronic diseases by using mobile and internet to build up self-management system. The telecare system may provide multidisciplinary web-based educational, monitoring, and communication platform and help IC/BPS patients understanding of the interplay between symptom and quality of life, which resulted in increased motivation to follow treatment, awareness of management when symptom flared up, and participation in care. The aim of our study is to develop and investigate a video-based telecare system with contents of health education and communication of emergent outbreak to improve the quality of life for IC/BPS patients.

Materials and Methods: This is a prospective randomized controlled study. A total of 56 IC/BPS patients were recruited from the urological clinic and randomly assigned to either the study group (N = 29) or the control group (N = 27). In this study, a mobile service designed for providing health education by using video-education system and administrating questionnaires were used for health care and health management of IC/BPS patients. Video-education system was designed as multi-dimensional patient education including avoiding some sensitive food, symptom flare up during and/or before menstrual cycle, the management of sexual pain, relaxation of pelvic floor muscle, and stress management. Instead of patient education, a mobile service also provided monitor and communication platform by checking the health status items. The questionnaires, including SF-36 health survey, visual analogue scales (VAS) for the measurement of pain and urgency, and O'Leary-Sant symptom (ICSI) and problem index (ICPI), were administrated to measure the patient perception of health status before (pre-test) and after (post-test) video-education spanning a period of 8 weeks. Descriptive statistics were used to analyzed the demographic information, disease severity and questionnaires of the recruited patients, while the inferential statistics were applied to compare the improvement of health status and symptoms between the study and control groups, as well as between pre-test and post-test for both groups. General linear model was also used to compare 2 repeated measures (pre- and post-tests) of the questionnaires between the control and study groups.

Results: The results showed that, except the mental health (p = 0.057), the other 7 constructs of SF-36 survey for the study group with m-health intervention exhibited significant improvement (p < 0.05) compared with those without intervention, indicating the QOL had been significantly improved. For disease severity, the study group also showed more significant improvements than the study group with regards to O'Leary-Sant (Symptom and Problem) scales (p < 0.05) and VAS-Urgency (p < 0.01) compared those without intervention. Moreover, by comparing the outcomes between the patients with video-based intervention and text-based intervention, the former group exhibited higher QOL improvement (p < 0.01) manifested in 5 SF-36 constructs (physical function, role physical, body pain, social function, and role emotion), while no significant improvement in disease severity was observed.

Conclusion: The intervention of video-based health education is effective in improving the QOL for BPS/IC patients. Moreover, video-based intervention outperformed the text-based intervention in consolidating good lifestyle, improving QOL, and alleviating disease symptoms.