Predictors of response and adherence to enuresis alarm therapy—a confirmatory study

• Published in: Acta Paediatrica Vol. 113; no. 3; pp. 573 - 579
• Main Authors: Bergsten, Amadeus, Larsson, Jens, Borgström, Malin, Karanikas, Birgitta, Nevéus, Tryggve
• Format: Journal Article
• Language: English
• Published: Norway Wiley Subscription Services, Inc 01.03.2024
• Subjects: adherence; Daytime; Enuresis; enuresis alarm; Urinary incontinence; adherence; enuresis alarm; enuresis
• ISSN: 0803-5253; 1651-2227; 1651-2227
• DOI: 10.1111/apa.17039

Aim To look for predictors to response and adherence to the enuresis alarm while exploring the possibility of families managing therapy independently. Methods We used a body‐worn alarm linked to a smartphone app. Subjects with enuresis were recruited both via paediatric nurses and independently as families bought the alarm and downloaded the app on their own. Results We recruited 385 nurse‐supported and 1125 independent subjects. Many (79.9%) dropped out before 8 weeks, but among adherent subjects 48.2% had a full or partial response. Age was a predictor of non‐response (p = 0.019). Daytime incontinence did not influence response. If enuresis frequency did not decrease during the first 4 weeks of therapy the chance of response was very small (p < 0.001). Adherence was higher among subjects supported by a nurse (p < 0.001), but for adherent subjects the outcome was similar regardless of nurse support (p = 0.554). Conclusions Daytime incontinence is no contraindication to enuresis alarm therapy. Treatment can be managed independently by the families, but adherence is enhanced by nurse support. Alarm treatment should be reassessed after 4 weeks. Enuresis alarm treatment guidelines need to be updated.