Feasibility of a Web-Based Self-management Intervention for Intermittent Urinary Catheter Users With Spinal Cord Injury

Wilde, Mary H.; McMahon, James M.; Fairbanks, Eileen; Brasch, Judith; Parshall, Robert; Zhang, Feng; Miner, Sarah; Thayer, Deborah; Schneiderman, Dan; Harrington, Brian E.

doi:10.1097/won.0000000000000256

Cited by 22 publications

(49 citation statements)

References 17 publications

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“…Structured social support was defined as any established system to check-in or provide support outside a traditional clinic setting. Two studies assessed the effects of telemedicine on UTI in NB with conflicting results: a 3-month study following 26 patients showed no UTI reduction after a telemedicine intervention ( 90 ). A study assessing 49 patients with NB found a significant reduction in UTI with telemedicine ( 91 ).…”

Section: Resultsmentioning

confidence: 99%

Systematic review and practice policy statements on urinary tract infection prevention in adults with spina bifida

Tradewell

Pariser

Nimeh

et al. 2018

Transl. Androl. Urol.

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Urinary tract infection (UTI) is a source of morbidity and healthcare costs in adults with spina bifida (ASB). UTI prevention strategies are often recommended, but the evidence of various approaches remains unclear. We performed a systematic review to inform a best practice policy statement for UTI prevention in ASB. On behalf of the Neurogenic Bladder Research Group (NBRG.org), we developed an a priori protocol and searched the published English literature for 30 outcomes questions addressing UTI prevention in ASB. The questions spanned the categories of antibiotics, oral supplements, bladder management factors and social support. Where there was little literature in ASB, we included literature from similar populations with neurogenic bladder (NB). Data was abstracted and then reviewed with recommendations made by consensus of all authors. Level of Evidence (LoE) and Grade of Recommendation (GoR) were according to the Oxford grading system. Of 6,433 articles identified by our search, we included 99 publications. There was sufficient evidence to support use of the following: saline bladder irrigation (LoE 1, GoR B), gentamicin bladder instillation (LoE 3, GoR C), single-use intermittent catheterization (IC) (LoE 2, GoR B), hydrophilic catheters for IC (LoE 2, GoR C), intradetrusor onabotulinumtoxinA injection (LoE 3, GoR C), hyaluronic acid (HA) instillation (LoE 1, GoR B), and care coordination (LoE 3, GoR C). There was sufficient evidence to recommend against use of the following: sterile IC (LoE 1, GoR B), oral antibiotic prophylaxis (LoE 2, GoR B), treatment of asymptomatic bacteriuria (LoE 2, GoR B), cranberry (LoE 2, GoR B), methenamine salts (LoE 1, GoR B), and ascorbic acid (LoE1, GoR B). There was insufficient evidence to make a recommendation for other outcomes. Overall, there are few studies in UTI prevention in the specific population of ASB. Research in populations similar to ASB helps to guide recommendations for UTI prevention in the challenging patient group of ASB. Future studies in UTI prevention specific to ASB are needed and should focus on areas shown to be of benefit in similar populations.

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Section: Resultsmentioning

confidence: 99%

Systematic review and practice policy statements on urinary tract infection prevention in adults with spina bifida

Tradewell

Pariser

Nimeh

et al. 2018

Transl. Androl. Urol.

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“…Different aims and outcomes, and lack of information about selection criteria, different categories, and modalities, are weaknesses in the studies. As commented by Wilde et al [31], "because of the small the number of participants, small changes could not reach significance, even if there was a trend". These small sample sizes, makes it difficult to make any unified recommendations for the whole SCI population [31] or for further development.…”

Section: Discussionmentioning

confidence: 98%

“…[31][32][33]35]. In a pilot study [31] of a web-based self-management system for people with SCI utilizing intermittent catheterization (IC), 30 persons with SCI were enrolled, and 22 completed the entire program, which included three phone calls with a continence nurse and an online forum. The study also tested new selfefficacy-scales and self-management scales at the beginning and end of the study; however, they found no statistically significant improvement.…”

Section: Web-based Treatmentsmentioning

confidence: 99%

“…The study also tested new selfefficacy-scales and self-management scales at the beginning and end of the study; however, they found no statistically significant improvement. According to the authors, this study "indicates that a web-based education program, following inpatient rehabilitation and also years after IC training, particularly when supported by phone, nursing consultation and online discussion, is likely to be well received by people who have a SCI [31]".…”

Section: Web-based Treatmentsmentioning

confidence: 99%

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Telehealth for people with spinal cord injury: a narrative review

et al. 2018

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Study design Narrative review. Objectives To find and discuss what has been published about the use of telehealth, on people with spinal cord injury (teleSCI). Setting International. Method Cochrane Library, Ovid Medline, EMBASE and CINAHL, from 1996 till June 2017 have been searched. Searches in PsycINFO, from 1996 till September 2017, were included afterwards. Extracted data include studies in English language, containing information about spinal cord injury and disorders, and telehealth. Literature reviews, systematic reviews, and studies containing other types of neurological disorders, were excluded. Studies were grouped based on how and to whom telehealth was offered.Results Twenty nine studies were included in the review. They were categorized according to the way teleSCI was provided, and to what modality was used. Some studies utilized more than one modality. TeleSCI seems to be favorable concerning treatment and follow-up, as well as favorable socioeconomically and environmentally. The studies spanned across several aims and outcomes. There was also heterogeneity in number of participants, the differences in modalities, and in the level of evidence. Thus it was challenging to compare studies and make future recommendations. Conclusions TeleSCI can be used for examination and guiding purposes. Further research is warranted to evaluate optimal utilization, methodology and efficacy. Sponsorship The first author has received funding from the Norwegian Extra Foundation.

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“…Moving CBT‐PMPs online addresses transport and operational barriers to implementation, reduces costs of programme delivery and increases the participant's autonomy in completing the programme at their own pace and preferred times (Griffiths, Lindenmeyer, Powell, Lowe, & Thorogood, ; Nguyen, Carrieri‐Kohlman, Rankin, Slaughter, & Stulbarg, ; Perry et al, ). While this mode of delivery has shown promising results for addressing depression, mood disorders and catheter management in SCI (Migliorini, Sinclair, Brown, Tonge, & New, ; Verwer, Leeuwen, Bolier, & Post, ; Wilde et al, ), it has yet to be undertaken for SCI specific CBT‐PMPs. Hence this RCT was undertaken to test the efficacy of Spinal Cord Injury Pain Ireland (SPIRE) pain management programme, an internet‐delivered CBT‐PMP for SCI pain.…”

Section: Introductionmentioning

confidence: 99%

An internet‐delivered cognitive behavioural therapy pain management programme for spinal cord injury pain: A randomized controlled trial

Burke

Lennon

Blake

et al. 2019

European Journal of Pain

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Background Chronic pain is common after spinal cord injury (SCI) and dedicated SCI cognitive behavioural therapy pain management programmes (CBT‐PMPs) have a growing evidence base to support their uptake clinically. The development of internet‐delivered treatment options may overcome barriers to the access and uptake of centre‐based programmes. This study examines such an approach on quality of lie (QoL), pain, mood and sleep. Methods Adults with SCI pain (>3 months) were recruited and randomly assigned to the intervention or control group. The intervention comprised a six module CBT‐PMP delivered once weekly. A blinded assessor determined changes in self‐reported outcome measures post‐intervention and at 3 months. Linear mixed models and effect sizes based on changes between groups were reported. Significance was set p < 0.05. Results The recruitment rate was 32% (intervention n = 35, control n = 34), and the drop‐out rate at 3 months was 26%. On average, participants accessed three (SD 2.1) of six modules. While no difference in QoL was reported, a significant group*time interaction was found for NRS of current pain (χ2 = 8.22, p = 0.016), worst pain (χ2 = 11.20, p = 0.004), and Brief Pain Inventory (interference) (χ2 = 6.924, p = 0.031). Moderate to large effect sizes favouring the intervention were demonstrated at each time point for the pain metrics (Cohen's d: 0.38–0.84). At 3‐month follow‐up, 48% of the intervention group rated themselves improved or very much improved (p < 0.05). Conclusions This study demonstrates the potential of an internet‐delivered SCI specific CBT‐PMP in reporting significant statistical and clinical benefit in pain intensity and interference. Strategies to improve engagement are needed.

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Feasibility of a Web-Based Self-management Intervention for Intermittent Urinary Catheter Users With Spinal Cord Injury

Cited by 22 publications

References 17 publications

Systematic review and practice policy statements on urinary tract infection prevention in adults with spina bifida

Systematic review and practice policy statements on urinary tract infection prevention in adults with spina bifida

Telehealth for people with spinal cord injury: a narrative review

An internet‐delivered cognitive behavioural therapy pain management programme for spinal cord injury pain: A randomized controlled trial

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