Page 1 - Poster Sessions] CUA 2022 Annual Meeting Abstracts

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2022 CUA ABSTRACTS

CUA 2022 Annual Meeting Abstracts – Poster Session 1: Urinary

Incontinence and Voiding Dysfunction

Saturday, June 25, 2022 • 16:00–17:30

Cite as: Can Urol Assoc J 2022;16(6Suppl1):S23-7. http://dx.doi.org/10.5489/cuaj.7923

MP-1.2 MP-1.4
Use of sound waves through smartphone to monitor urinary flow Treatment patterns in men prescribed benign prostatic obstruction
patterns among rural northern Ontario residents — a potential or overactive bladder medications: A Canadian, retrospective,
digital health strategy? population-based study
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Okechukwu Abara , Sebastian Diebel , Ndidi Abara 3 Sender Herschorn , Sarah Neu , Rano Matta , Jennifer A. Locke , Rodrigo
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1 Division of Urology, Department of Surgery, NOSM Medical University, Martins de Almeida , Lora Todorova , Matthias Stoelzel , Patrick Covernton 3
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Sudbury/Thunder Bay, ON, Canada; Undergraduate Medical Education, 1 Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON,
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NOSM Medical University, Sudbury/Thunder Bay, ON, Canada; Yuma Canada; Division of Urology, University of Utah, Salt Lake City, UT, United
Regional Medical Center, University of Arizona College of Medicine, Yuma, States; Astellas Pharma Europe, Woking, United Kingdom; Astellas Pharma
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AZ, United States Europe B.V., Leiden, Netherlands
Support: Ontario Health (OTN) Introduction: Lower urinary tract symptoms include voiding, often indica-
Introduction: Monitoring urinary flow patterns of our patients remains a tive of benign prostatic obstruction (BPO), and storage symptoms, poten-
function of the urologist. There are many devices that serve this purpose, tially indicative of overactive bladder (OAB). This study aimed to describe
and some are home-based. Recent interest in audio-based uroflowmetry real-world treatment patterns for BPO and OAB in Canadian men and
applications makes telemedicine and smartphone technologies potential identify gaps in their treatment.
drivers for self-empowerment, improved access, and home-based care. Methods: This population-based, retrospective cohort study was completed
Between June 15, 2021, and February 18, 2022, we evaluated the use of using linked health administrative databases in Ontario, Canada. From
a publicly available electronic uroflow application (app) among residents 2010–2018, males aged ≥66 years with ≥1 prescription for an OAB or
of rural Northern Ontario to determine if the participants were able to BPO medication were included. The primary objective was to determine
download the app, generate data, and send it to their urologist for review time from initiation of OAB/BPO treatment to change in therapy (time-to-
and treatment decisions event analysis). A secondary objective was to compare healthcare costs
Methods: Inclusion criteria were: adults >18 years; own smartphone; inter- between both groups.
net access; and referred with a urological condition. Informed consent was Results: Age at index, geographic region, and income were similar between
in English/French. Following a telemedicine assessment, participants were groups (OAB: n=9229 [5.8%]; BPO: 151 055 [94.2%]). Median (inter-
given unique ID numbers and were asked to download the app, use it on quartile range [IQR]) followup was: OAB 1480 (873–2310); BPO 1622
four consecutive days for all urination activities, and send data (International (932–2475) days. The most common first-line OAB medication class was
Prostate Symptom Score [IPSS], uroflow tracings) to their urologist. There antimuscarinics (78.1%; second-line: alpha-blockers, 63.1%); for BPO,
was a followup virtual care visit to review data and treatment options. first-line alpha-blockers were most common (90.8%; second-line: 5-alpha
Feedback was obtained by an online survey. Data collection and analysis reductase inhibitors, 58.8%). Mean age at medication initiation in both
were done via Excel and descriptive statistics. The study was approved by groups was 75 years. Relative to the OAB group, men in the BPO group
the Laurentian University Ethics Review Board. were less likely to experience a therapeutic change and had longer times
Results: Out of the 40 participants, 28 (70%) were men and 12 (30%) to first change in therapy (OAB: median [IQR] days 78 [30, 231]; BPO:
women, between 22 and 75 years old (average 64 years). Thirty-six of 40 104 [30, 350]) (Figure 1, Table 1). The most frequently observed first thera-
(90%) completed the trial. Urological conditions included benign pros- peutic change (Table 2) in both groups was treatment discontinuation (OAB:
tatic hyperplasia, prostate cancer, voiding dysfunction, overactive bladder, 75.6%; BPO: 69.9%). Mean healthcare costs were higher in the OAB vs.
hematuria, stones, kidney cancer, and bladder cancer. Most participants the BPO group, both in the pre- (OAB: $12 354 vs. BPO: $11 497) and
continued to use the app and send data after four days (max 60 days, post-index years (OAB: $14 423 vs. BPO: $12 852).
average 12.9 days). All volunteers found the app easy to use. It was simple Conclusions: In this population, men initiating OAB medications changed
and provided convenient, multiple urination data for individualized care. therapy sooner compared to those starting BPO medications. In both groups,
There were a few technical issues, all of which were were resolved. There discontinuation was the most common change in therapy.
were no comparative studies.
Conclusions: A smartphone app using sound waves is a simple and conven-
ient tool that can potentially provide important urination data for monitoring
and therapeutic purposes. Multicenter trials and comparative studies are
recommended.

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