open access publication

Preprint, 2024

Evaluation of a novel digital ostomy device on leakage incidents, quality of life, mental well-being, and patient self-care: an interventional, multicentre clinical trial

medRxiv, Page 2024.06.10.24308691, 10.1101/2024.06.10.24308691

Contributors

Brady, Richard R W 0000-0002-1905-6384 [1] Sheard, Diane [2] Alty, Mandie [2] Vestergaard, Martin Risom 0000-0002-3840-3193 [3] Boisen, Esben Bo 0000-0003-0466-2573 [3] Ainsworth, Rachel [4] Hansen, Helle Doré [3] Ajslev, Teresa Adeltoft 0000-0003-3129-0568 (Corresponding author) [3]

Affiliations

  1. [1] Newcastle University
  2. [NORA names: United Kingdom; Europe, Non-EU; OECD];
  3. [2] Royal Preston Hospital
  4. [NORA names: United Kingdom; Europe, Non-EU; OECD];
  5. [3] Coloplast (Denmark)
  6. [NORA names: Coloplast; Private Research; Denmark; Europe, EU; Nordic; OECD];
  7. [4] Coloplast (United Kingdom)
  8. [NORA names: United Kingdom; Europe, Non-EU; OECD]

Abstract

Abstract Background Most people with a stoma worry about leakage, and a quarter experience leakage of stomal effluent outside baseplate on a monthly basis. Leakage has additional physical and psychosocial consequences, for instance peristomal skin complications, feeling unable to cope and self-isolation. Method An interventional, single-arm, multi-centre, study was undertaken in United Kingdom, to evaluate a novel digital leakage notification system for ostomy care including a Support Service (=Test Product) for 12 weeks in patients with a recent stoma formation (≤9 months). Patients completed questionnaires at baseline and after 4, 6, 8, 10 and 12 weeks, evaluating leakage episodes, Ostomy Leak Impact (tool containing three domains) and patient self-management (by PAM-13). Additionally, mental well-being (by WHO-5) and quality of life (QoL) (by EQ-5D-5L) were assessed. Outcomes between baseline and final evaluation were compared by generalised linear- and linear mixed models. Results 92 patients (ITT population) were recruited with a mean age of 49.4-years (range 18-81 years). 80% had an ileostomy and 53% were female. After 12 weeks use of the Test Product, a significant decrease in mean episodes of leakage outside the baseplate (1.57 versus 0.93, P <0.046) was observed. Ostomy Leak Impact scores improved across all three domains ( P <0.001), indicating less embarrassment, increased engagement in social activities, and increased control. Patient self-management also improved significantly (PAM-13 score: Δ6.6, P <0.001), as did the WHO-5 well-being index (Δ8.0, P <0.001). Lastly, EQ-5D-5L-profile-scores tended to improve ( P =0.075). Conclusion A new digital leakage notification system demonstrated strong improvements to patients’ stoma self-care, mental well-being, and QoL. What does this paper add to the literature? Sensor technology embedded in supporting ostomy solutions can notify users about leakage seeping underneath the baseplate and thus secure a timely change of the baseplate before effluent may reach outside the baseplate soiling clothes or bedsheets. The technology showed potential in increasing quality of life for people with a stoma.

Keywords

EQ-5D-5L, ITT, ITT population, Kingdom, PAM-13, QoL, QoL., United Kingdom, WHO-5, WHO-5 Well-Being Index, Well-Being Index, activity, age, baseline, baseplate, basis, bedsheets, care, clinical trials, clothing, complications, consequences, control, decrease, devices, domain, effluent, embarrassment, engagement, episodes, episodes of leakage, evaluation, experience leakage, experiments, formation, ileostomy, impact, impact scores, improvement, incidence, increase quality, increased control, increased engagement, increased quality of life, index, leakage, leakage episodes, leakage incidents, life, linear mixed models, linearity, literature, mental well-being, method, mixed models, model, monthly basis, months, multi-centre, multicentre, multicentre clinical trial, notification system, ostomy, ostomy care, ostomy devices, outcomes, patient self-care, patient self-management, patients, people, peristomal skin complications, population, potential, production, psychosocial consequences, quality, quality of life, questionnaire, scores, self-care, self-isolation, self-management, sensor, sensor technology, single-arm, skin complications, social activities, soiled cloths, solution, stoma, stoma formation, stoma self-care, stomal effluent, study, support, system, technology, test, test product, trials, units, use, users, weekly use, weeks, well-being

Data Provider: Digital Science