Evidence map›Paper›PMID 41071602›Full record

Trial reportJournal of medical Internet research2025

Smart Continence Care for People With Profound Intellectual and Multiple Disabilities Within Dutch Residential Care Facilities: Economic Evaluation Alongside a Cluster Randomized Trial.

Vivette Jc van Cooten, Ghislaine Apg van Mastrigt, Andrea Gabrio, Silvia Maa Evers, Marieke Fm Gielissen, Brigitte Boon

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of medical Internet research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05481840 (The), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05481840 naunknown statusnot on this map

The (Cost)Effect of Continence Material With Sensor for People With Profound Intellectual and Multiple Disabilities: Client-based Continence Care by Innovation

TypeinterventionalSponsorAcademy Het DorpRan2021 to 2023Enrolled160ConditionsIncontinenceArmsContinence material with sensor
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Vivette Jc van CootenAcademy Het Dorp, Research & Advisory on Technology in Long-term Care, Arnhem, The Netherlands.ORCID https://orcid.org/0000-0002-6990-0694
Ghislaine Apg van MastrigtDepartment of Health Services Research, Care and Public Health Research Institute (Research Institute CAPHRI), Faculty of Health Medicine and Life Science, Maastricht University, Maastricht, The Netherlands.ORCID https://orcid.org/0000-0001-8053-5512
Andrea GabrioDepartment of Methodology and Statistics, Care and Public Health Research Institute (Research Institute CAPHRI), Faculty of Health Medicine and Life Science, Maastricht University, Maastricht, The Netherlands.ORCID https://orcid.org/0000-0002-7650-4534
Silvia Maa EversDepartment of Health Services Research, Care and Public Health Research Institute (Research Institute CAPHRI), Faculty of Health Medicine and Life Science, Maastricht University, Maastricht, The Netherlands.ORCID https://orcid.org/0000-0003-1026-570X
Marieke Fm GielissenAcademy Het Dorp, Research & Advisory on Technology in Long-term Care, Arnhem, The Netherlands.ORCID https://orcid.org/0000-0002-9943-8197
Brigitte BoonAcademy Het Dorp, Research & Advisory on Technology in Long-term Care, Arnhem, The Netherlands.ORCID https://orcid.org/0000-0001-9340-9304

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPersons with profound intellectual and multiple disabilities in residential care facilities may benefit from smart continence care (SCC), which is incontinence material (IM) with integrated sensors that notify caregivers when the IM is saturated and requires changing. SCC aims to reduce weekly leakages and improve the quality of life.

objectiveGiven the growing demand for health care services and the decreasing workforce, it is essential to assess the cost-effectiveness and cost-utility of such technologies.

methodsThis economic evaluation was conducted alongside a cluster randomized trial across 6 care organizations in the Netherlands. The incremental cost-effectiveness ratio (ICER) was expressed as the additional societal costs of SCC in relation to a reduction in weekly leakages. The incremental cost-utility ratio used Quality Adjusted Life Years measured via the EQ-5D-5L proxy 1 version. Robustness was assessed using bootstrapping, sensitivity, and subgroup analyses for variations in pricing and alternative outcomes (weekly IM changes [IMCs] and time savings). The study period was 12 weeks.

resultsThe analyses included 74 participants in the regular continence care (RCC) group and 82 participants in the SCC group. Analyses were corrected for baseline differences in the time spent on continence care and utility. SCC is found to be less effective (-1.058, 95% CI -1.878 to -0.262) and more costly (US $371, 95% CI US$ -0.09 to $771) than RCC for the number of leakages as the outcome, placing the ICER in the northwest (NW; inferior) quadrant of the cost-effectiveness plane. Cost-utility analyses showed a high uncertainty, with results in both the NW and northeast quadrants. Scenario analysis suggested that the negative effect on leakages was due to implementation challenges. Sensitivity analyses showed that the supplier's new pricing model had a slight positive effect, reducing the estimated total societal costs, although uncertainty remains. SCC was estimated to effectively reduce weekly IMCs (ICER in the northeast quadrant) but did not save time (ICER in the NW quadrant).

conclusionsThe results of this economic evaluation are not conclusive because of the mixed outcomes and a limited timeframe. SCC is ineffective in reducing the number of weekly leakages, but it does reduce the number of weekly IMCs. However, SCC was not effective in reducing time spent on continence care. Findings suggest that SCC is expected to be more expensive than RCC, although the supplier's new pricing model may decrease costs. The use of technologies such as SCC should not solely be based on cost-effectiveness and cost-utility outcomes. This technology offers value by generating data that can support personalized care. However, the realization of this added value is not guaranteed and may differ between individuals. Implementation challenges and individual variability underline the need for tailored approaches.

trial registrationClinicalTrials.gov NCT05481840; https://clinicaltrials.gov/ct2/show/NCT05481840.

Indexed as

Fecal IncontinenceIntellectual DisabilityPersons with DisabilitiesResidential FacilitiesUrinary IncontinenceAdultCost-Benefit AnalysisFemaleHumansMaleMiddle AgedNetherlandsQuality-Adjusted Life YearsQuality of Lifecontinence carecost-effectivenesscost-utilityeconomic evaluationeHealthprofound intellectual and multiple disabilitiestechnology

Identifiers

PMID41071602
PMCPMC12552815

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.