To analyse mobile technologies and websites designed for the self-management of bladder health (BH) and/or urinary incontinence (UI) in adults aged 50 and over.

Rapid review of digital solutions (mobile applications and websites) that include behaviour change techniques (BCTs) and elements of gamification (protocol registered in Prospero CRD42024597624). The search started in July 2024 and updated in January 2025 in: 1) the app market  (Google Play Store and Apple App Store in Spain, Lithuania, and the United Kingdom)); 2) websites (80 results in Google for each country); 3) academic databases (PubMed, Scopus, CINAHL, Google Scholar for journal articles, book chapters, and full-length conference papers published in English, Spanish, or Lithuanian). Inclusion criteria: apps or websites that can be used without supervision by a healthcare professional, regardless of cost (e.g., to download or to access in-app functions), with at least one BCT (e.g., training, education, monitoring, prompting), evidence-informed (i.e., have included participants aged ≥50 years in the design or piloting phase or target this group), available in Spain, the UK or Lithuania. The 19-item Mobile App Rating Scale (MARS) was used to assess the quality of the smartphone apps (1). We used the taxonomy of 93 BCTs developed by Michie et al. (2; the total score for each app ranged from 0 to 93, based on the number of considered BCTs. All previous processes and data extraction were conducted in duplicate.

21 articles were included, covering 8 smartphone applications and 1 website. Of the 8 applications we identified in the articles, only 2 of them (Tät, UrinControl) were available in Google Play or the Apple App Store. In Lithuania, no apps were found. In Spain, we identified only one app (URinControl), while in the UK, we identified 3 relevant apps (URinControl, URinControl4all, and BladderBoss). BladderBoss was available on both Google Play and the Apple App Store (in different versions), whereas the other apps were only available in one of the stores. Table 1 presents the technological and quality information of the apps. The apps contained a minimum of 7 BCTs, related to goals and planning, feedback and monitoring, shaping knowledge, comparison of behaviour, repetition and substitution and comparison of outcomes the most used (Figure 1). The website search did not identify any platforms with scientific evidence supporting their effectiveness across the three countries. Only one website with scientific evidence was found in a scientific article from the search: www.tät.nu.

Eleven apps were identified from the articles and app store searches.  Only 4 applications met the criteria of both scientific validation and mobile availability: URinControl, Tät®, URinControl4all, and BladderBoss. The latter had the highest score for both MARS and BCTs. All applications were assessed as being of acceptable-good quality (between 3 and 4 points). The review found that mobile applications may effectively improve urinary continence and quality of life, with Tät and Tät II showing significant benefits, while outcomes varied based on adherence, personality, routine integration, and prior experience.  Barriers include unrealistic expectations and adherence challenges. The main study limitation is the restriction to three countries.

Only 4 evidence-based applications are available for download in Lithuania, Spain, and the UK. The findings highlight the need for personalised, evidence-based digital interventions to improve adherence, usability, and therapeutic outcomes among adults aged 50 and over.

Michie, S., Wood, C. E., Johnston, M., Abraham, C., Francis, J. J., & Hardeman, W. (2015). Behaviour change techniques: The development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data). Health Technology Assessment (Winchester, England), 19(99), 1-188. https://doi.org/10.3310/hta19990.
Stoyanov SR, Hides L, Kavanagh DJ, Zelenko O, Tjondronegoro D, Mani M. Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR Mhealth Uhealth. 2015 Mar 11;3(1):e27. doi: 10.2196/mhealth.3422.