Patients who suffer from overactive bladder (OAB) now have access to an innovative, virtual treatment program developed at The Ohio State University Wexner Medical Center that uses the Epic MyChart app.
The OAB pathway was developed by Irene Crescenze, MD, along with Latisha King and Shonda Vink of the MyChart IT team at the Ohio State Wexner Medical Center.
“The MyChart Care Companion OAB care plan takes patients through a systematic, evidence-based treatment pathway to encourage patients to learn about the disease and how to manage their bladder symptoms from the comfort of their own homes,” says Dr. Crescenze, who specializes in female pelvic medicine and reconstructive urology. “The care pathway is modeled after OAB guidelines created by the American Urological Association and the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction.”
Through the app, patients learn about OAB disease, symptom triggers, behavioral modifications and treatment options.
“Comprehensive and cost-effective treatment programs for OAB are important,” Dr. Crescenze says. “OAB affects about 20% of patients in the U.S., and the incidence increases drastically with age. It has a significant negative impact on quality of life, including persons’ self-esteem, work and occupation, family relationships, and sexual function.”
OAB poses a tremendous financial burden both on patients and the health care system. Successful treatment of OAB relies heavily on patient education to encourage compliance with behavioral modifications, and it often can’t be accomplished during a 15-minute office visit.
Virtual steps and pathways to manage overactive bladder
Dr. Crescenze and her team at the Ohio State Wexner Medical Center rolled out OAB MyChart Care Companion in August 2020. Here’s how the app works:
Care Companion Step 1
To begin Step 1, the patient visits the physician—either in the office or via telehealth. The physician assesses symptoms, discusses testing options, and explains overactive bladder and what to expect during treatment. If the patient qualifies, they are enrolled into the OAB Care Companion Pathway.
At home, the patient uses the app to learn more about OAB and how to manage overactive bladder by making certain lifestyle and behavioral changes, such as diet choices, fluid management and pelvic floor exercises.
“The Care Companion pathway is a patient care tool. It helps us disseminate education on OAB care and guide patients through the behavioral modification process automatically,” Dr. Crescenze explains. “Patients often have significant symptom improvements when they make the proper lifestyle and behavioral changes.”
At the end of Step 1, the app will ask the patient: “Are you better?” If yes, the patient will be advised to stick with the care plan and see their doctor regularly.
Care Companion Step 2
If the patient has not experienced symptom relief during Step 1, the Care Companion care plan will guide patients to Step 2, the pathway on which the patient will learn about options for medications. Again, the app will ask the patient if there’s improvement in their condition. If the answer is yes, the patient is advised to continue the medicine and see the doctor regularly. If bladder symptoms have not improved, the patient is advised to ask the doctor about potential adjustments to the medicine.
Care Companion Step 3
If medication adjustments don’t help the patient during Step 2, the patient is prompted to move along the pathway to Step 3. During Step 3, the patient will learn about advanced therapies to treat overactive bladder, including:
- Sacral nerve stimulation (SNS)
- Botox bladder injections
- Percutaneous tibial nerve stimulation
Convenient voiding diaries and interactive educational elements
As patients navigate the treatment pathways, the MyChart Care Companion care plan offers a host of virtual features to treat overactive bladder. These features include:
- Voiding diary – Virtual voiding diary allows patients to keep track of their bladder symptoms directly on their phone using the app. This information is directly linked to their electronic medical chart and can be easily viewed by the physician.
- Validated questionnaires – Virtual OAB and incontinence questionnaires are administered at baseline and then regular intervals to assess patients’ progress with treatment. Physicians can use the questionnaire to establish a baseline of how severe the overactive bladder issues are and to track outcomes. This can be shared and even graphed to demonstrate success over time.
- Medication compliance – It’s known that 60 – 80% of patients with OAB aren’t compliant with their medications and discontinue medicine within a year. The app helps assess the medication compliance at regular intervals.
- Educational materials – Patients are “assigned” reading materials about treating and managing overactive bladder at regular intervals to help empower and guide them as they make necessary changes to improve their bladder health. As patients complete each reading, they receive a completion checkmark.
“The patient education component of the app is key throughout the pathway treatment process. It allows patients to take ownership of their health, empowers them to make the necessary changes, and finally helps them get educated about treatment options. If patients reach the end of the pathway and need to talk about advanced therapies, they’re informed even before the follow-up visit because they’ve been reading about their options through the app,” Dr. Crescenze explains. “They know what questions to ask their doctors, and they can make an educated decision about what is a good next step for them.”
An app solution that saves time and money and leads to better patient care
Through OAB MyChart Care Companion, doctors can deliver personalized, comprehensive care for patients with OAB while minimizing the cost and time burden on the patient and the health care system.
Successful treatment of any chronic illness, and specifically OAB, relies heavily on a patient’s engagement, behavior modification and compliance with treatment to achieve the best possible outcomes.
Now, the MyChart Care Companion offers a cost-effective solution.
“This is the primary benefit. My patients can access this free and valuable education any time,” Dr. Crescenze says.
Right now, Dr. Crescenze considers the app to be in a pilot phase. Her goal is to conduct a randomized controlled trial to see if Care Companion will improve treatment and outcomes. She and her team at the Ohio State Wexner Medical Center are eager to make the platform as user-friendly as possible.
“In the future, we look forward to expanding the app and using it with other urologic conditions as well,” Dr. Crescenze says.