A Norwegian study published in 2001 reports that home-managed electrical stimulation (ES) can be introduced and implemented effectively as a treatment for urinary incontinence1. In all, 3,198 women were treated with ES after their doctors recommended this form of treatment. ES is now a reimbursed, home-managed treatment option in Norway offered to patients both young and old.
Norwegian National Insurance decided in 1992 that the documented need for home-managed electrical stimulation was sufficient to warrant a national project to aid in implementation and reimbursement of electrical stimulation devices. All physicians in Norway could request low-frequency stimulators for treating patients with urge or mixed incontinence or high-frequency stimulators for treating stress or mixed incontinence. The development of portable, easy-to-use, insurance-reimbursed electrical stimulators enabled physicians to recommend them for this study as a home-managed treatment option after required patient education on its use.
In the study presented here, 3,198 patients received an electrical stimulation device from a total of 645 physicians over the course of a 24-month period, split almost evenly between high and low frequency devices. The majority of women treated had previously tried other treatments including pelvic floor exercise, bladder training, oestrogen, and surgery. Fifty-five percent of women had symptoms for 5 years or more with 62% having urinary loss every day/night, and 59% classified as severely or very severely incontinent. The largest treatment group held the highest incidence of stress urinary incontinence and consisted of women within the age-range of 40-49.
This study concluded that physician involvement in combination with insurance coverage and ease-of-use aided in the successful transition to new home-managed treatment for urinary incontinence. The study calls it “a numeric success” in the area of reimbursement for urinary incontinence as it has shown that it is possible to reach a wide age group with a wide distribution of diagnoses levels and implement electrical stimulation as a treatment option for everyday use.
1 Solfrid Indrekvam, Ole A. Kragh Fosse, Steinar Hunskaar (2001) “A Norwegian National Cohort of 3198 Women Treated with Home-managed Electrical Stimulation for Urinary Incontinence: Demography and Medical History”, Scandinavian Journal of Urology and Nephrology, 35:1, 26-31.