A Randomized Controlled Trial of a Web-Based Management Support System for Children with Urinary Incontinence: The eADVICE Trial.

Children referred to specialist outpatient clinics by primary-care providers often have long waiting times before being seen. We assessed whether an individualized, web-based, evidence-informed management support for children with urinary incontinence while waiting reduced requests for specialist appointments. A multicenter, waitlisted randomized controlled trial was conducted for children (5-18 years) with urinary incontinence referred to tertiary pediatric continence clinics. Participants were randomized to web-based eHealth program 'eADVICE', which used an embodied conversational agent to engage with the child at the time of referral (intervention) or 6 months later (control). The primary outcome was the proportion of participants requesting a clinic appointment at 6 months. Secondary outcomes included persistent incontinence, and the Paediatric incontinence Questionnaire (PinQ) score. From 2018 to 2020, 239 children enrolled, with 120 randomized to eADVICE and 119 to the control arm. At baseline, participants' mean age was 8.8 years (SD 2.2), 62% were males, mean PinQ score was 5.3 (SD 2.2), 36% had daytime incontinence and 97% had nocturnal enuresis. At 6 months 78% of eADVICE participants versus 84% of controls requested a clinic visit (RR 0.92, 95% CI 0.79, 1.06, The eADVICE eHealth program for children awaiting specialist appointments doubled the proportion who were dry at 6 months and improved quality of life but did not reduce clinic appointment requests. The Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12618001484235.