Algorithm-based Mobile Texting Platform for the Self-management of Interstitial Cystitis/Bladder Pain Syndrome: Pilot Study Evaluating Feasibility, Usability and Potential Utility.

ABSTRACT

INTRODUCTION: We developed an algorithm-based mobile texting platform for promoting self-management in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Our aim was to measure the feasibility, usability, and potential utility of the platform. MATERIAL AND METHODS: A texting platform that delivered four treatment modules (education and behavioral modification, cognitive behavioral therapy, pelvic floor physical therapy, and guided mindfulness practices) and an automated weekly message over six weeks was developed. Feasibility and usability were determined using patient engagement (proportion of platform messages to which patients responded) and System Usability scale. Satisfaction with patient-physician communication questionnaire, Pain Self-Efficacy Scale, and Interstitial Cystitis Symptom and Problem Index were administered before and after the intervention. RESULTS: Engagement with the platform in 52 female patients with IC/BPS [median age (IQR) 40 (30-48) years] was 76.9%. The commonest module selected by patients was pelvic floor physical therapy (50%) followed by cognitive behavioral therapy (34%), and guided mindfulness (15%). System Usability score (median, IQR) was 87 (83-95), indicating high usability. Satisfaction with patient-physician communication improved significantly (median change 4, IQR 1-9, p< .001). Pain self-efficacy score improved from moderate impairment at baseline to minimal impairment at six weeks (median change 10, IQR 2-18, p < .001). Urinary symptoms scores also improved (median change Interstitial Cystitis Symptom Index -3, IQR -5, -1.5, p < .001, Problem Index -2, IQR 5.5, -0.5, p <.001). CONCLUSION: An automated mobile platform has the potential for improving access to self-management strategies and easing clinicians' challenge of counseling IC/BPS patients during time-limited in-person visits.