In-home use study evaluating user satisfaction with newly developed MoliCare Premium Pants

Incontinence is a widespread health issue affecting hundreds of millions of people worldwide, and its prevalence increases with age. Both urinary and faecal incontinence range from occasional and irregular to continuous and are light or heavy in volume (Bardsley, 2016; Buckley, 2019; Pizzol et al, 2021; Vaittinen et al, 2024). The embarrassment and stigma associated with incontinence restrict social and professional activities, which can negatively impact wellbeing and quality of life (Paterson et al, 2003).

Incontinence can impair skin integrity, making patients susceptible to skin breakdown, such as pressure injuries and incontinence-associated dermatitis (IAD). IAD is clinically observed as inflammation and erythema due to chronic exposure of the skin to urine and faecal material (Kayser et al, 2021). This condition can be painful and is a risk factor for secondary skin infections (Raepsaet et al, 2021).

The acidic pH of the skin surface, the so-called acid mantle, provides a protective barrier against microbial invasion. Any alteration in skin pH from the normal acidic pH of 4–6 to an alkaline level can impair the mechanical integrity and barrier function of the skin, enhance the penetration of substances and promote bacterial growth. By maintaining pH within the normal acidic range, the skin provides an optimum environment for the activity of essential enzymes vital for the recovery of barrier function under pathogenic conditions. Repeated contact between skin and urine in an incontinent person macerates the skin, resulting in an elevated surface pH and barrier disruption (Ersser et al, 2005; Falloon et al, 2018; McNichol et al, 2018; Koudounas et al, 2022).

Although a wide range of therapies, surgeries and drugs may provide a cure or symptom improvement, many patients may not be candidates for treatment owing to their frailty, severity of incontinence and personal choices, and may choose management over attempted therapies. Most patients wish to deal with their incontinence to perform their daily activities confidently and reduce the detrimental effects on their quality of life (Getliffe et al, 2007; Fader et al, 2010; Diadiun et al, 2021).

The mainstay and daily management options for individuals experiencing incontinence involve the use of absorbent products to control and collect urine and faecal loss due to bladder and bowel dysfunction. Using such products can mitigate the possible clinical complications arising from incontinence, such as skin irritation, maceration and perineal dermatitis (DeMarinis et al, 2018).

Fortunately, a diverse range of absorbent continence products with various designs and absorbency levels have been developed to meet the needs of patients and their lifestyles (Fader et al, 2010; DeMarinis et al, 2018). However, product selection can be overwhelming and confusing for both users and clinicians because there are few published studies on product description and performance, as well as little postmarketing evaluation (Newman et al, 2004; Sanaeifar et al, 2023).

The choice of an absorbent continence product should be based on the volume of urine leakage, frequency of leakage, style and the ability of the consumer to apply the product. An effective product should be capable of absorbing urine at the highest possible flow rate, ensuring minimised skin exposure to urine and stool (DeMarinis et al, 2018; Buckley, 2019).

Factors influencing the effectiveness and acceptability of products fall into several broad categories, such as technical performance (eg absorbency, containment and leakage), comfort and reliability, ease of use, personal preferences and priorities, provision, and accessibility. Product developers and manufacturers should focus not only on technological challenges, but also on other features because it is impossible for any single product type to be considered suitable for all occasions. For instance, absorbency and skin irritation are considered crucial when a product is worn at night; hence, a bulky product might be acceptable to users, while discreetness and odour containment may be prioritised during social engagements (Buckley, 2019).

In the present study, the main goal was to investigate the key performance characteristics of the newly redesigned MoliCare Premium Pants based on the feedback of users with incontinence.

Methods

Study design

The focus of the study was to evaluate the key features of the new MoliCare design based on the feedback of participants.

Fifty-two women and men aged 45 years or older living in private households with light to severe urinary incontinence in Germany were recruited to evaluate the redesigned MoliCare product. The study was conducted between January and February 2021. All subjects used the same product category, Pants, size M or L, with a similar absorbency level. The product was blinded under hygienic conditions, marked with a code sticker, and provided to each participant free of charge for evaluation. Participants were surveyed regarding their experiences and views of various product characteristics via a computer-assisted personal interview.

Ethical considerations

This study fully complied with ethical, governance and data protection requirements.

Development of the survey for interview

The survey included demographic questions and information about degree of incontinence. A list describing various features of an absorbent incontinence product was designed, and participants were asked to select the 10 most important features and to rank them in order of importance. They were asked about their overall satisfaction with the test product and their level of agreement with the most important product performance characteristics.

Questions were answered using a 5-point scale – extremely satisfied/agree completely (point 1), very satisfied/agree (point 2), satisfied/neither agree nor disagree (point 3), less satisfied/disagree (point 4), and dissatisfied/disagree completely (point 5). For simplicity, the results are presented using a 3-point scale. As such, the ratings were combined into three categories ‘highly satisfied’/‘agree’ (sum of ratings 1 and 2), ‘satisfied’/‘neutral’ (rating of 3), and ‘dissatisfied’/‘disagree’ (sum of ratings 4 and 5).

The product

MoliCare pull-up pants is an incontinence product resembling elasticated underwear with an absorbent pad on the inside that provides long-lasting comfort to keep the patient active all day. This product is suitable for moderate-to-severe urinary or faecal incontinence in active patients and can be easily pulled up and down, allowing users to apply the product independently.

The MoliCare Premium Pants product has been upgraded using new technologies and materials to accommodate user preferences. In the absorbent core of the new design a curled fibre, a specially processed type of cellulose fibre modified in an acidic citric environment, was replaced by an acquisition distribution layer (ADL). The ADL, composed of non-woven fabric, accelerates moisture absorption and transportation to the inner absorbent core, and prevents moisture from returning to the topsheet under external pressure. ADL plays a key role in providing comfort and dryness, as well as minimising rewetting.

The new design has been modified with monosodium citrate to create an acidic surface environment when wet. Another key design feature is the inclusion of a channel-shaped cavity at the most probable urine entry point. This further accelerates urine absorption through quick and even distribution of liquids throughout the pad.

The lower elastic waistband in the newly redesigned MoliCare Premium Pants provides comfort, better discreetness, and better buttock coverage. The leg openings are optimised to match the body contours and improve the product fit, creating a more comfortable feeling and security. Figure 1 illustrates the new design.

Data analysis

All descriptive statistical analyses were performed using SPSSv24.0 (IBM Corp, Armonk, New York, USA).

Findings

Figure 2 presents an evaluation of the 10 most important features of the newly redesigned MoliCare product by the study participants (n=52). More than 85% of respondents identified absorption speed and odour containment as their priority performance aspects. The next most important feature, rated by 79% of participants, was leakage protection; 75% rated a secure feeling as one of their top 10 priorities; and 69% reported that the softness of the product was an essential characteristic. Absorbency, and fit and comfort, were given equal importance: 67% of the participants included both in their top 10 important aspects. The dry feeling of the product during entire wear time was considered important by 65% of respondents. Slightly less important product characteristics were that they stayed in place (does not slip when worn) (54%) and ease of use (52%).

Table 1 presents the evaluation of the characteristics of the new MoliCare Premium Pants design by study participants. At least 94% ‘agreed’ that each individual product feature performed very well. When asked about their overall satisfaction with the product, 83% and 15% were ‘highly satisfied’ and ‘satisfied’ with the new MoliCare design, respectively, while only 2% were ‘dissatisfied’. On urine absorption, 96% of the participants ‘agreed’ that the new design absorbed it quickly and completely, and prevented odour development. The majority of users (94%) ‘agreed’ that the product offered a high level of leakage protection, with only 2% disagreeing. The new design made 96% of respondents felt secure, with the same proportion finding the product to be soft and pleasant. There was equal agreement (94%) among users on the product's high absorbency, its fit and comfort, and dry feeling during the entire wear time, with less than 4% disagreeing on these aspects. Ninety six per cent of participants ‘agreed’ that the product remained in place and did not slip when worn, and all the respondents found the product easy to use.

Discussion

High-performing absorbent continence products play a key role in supporting individuals concerned about the psychosocial implications of incontinence, such as embarrassment due to visible leakage and the unpleasant smell of urine (DeMarinis et al, 2018). When choosing an continence product, essential criteria such as comfort, ease of use, leakage protection, discreetness, dryness, and absorbency should be fulfilled.

Few published data are available on patient perceptions and satisfaction with absorbent products. The authors evaluated the MoliCare absorbent product by asking users with urinary incontinence about their satisfaction level with its various performance characteristics. This product has been designed with consideration of user comfort, as well as addressing issues important for caregivers (the product is easy and quick to fit and can be performed with the patient standing), hence reducing the risk of back pain for the caregiver. Furthermore, the short application time minimises carers' hands-on involvement.

The new MoliCare design performs well in terms of various priority performance aspects. It is not surprising that the effectiveness of a product to absorb urine rapidly, and contain odour and urine without leakage is of great importance to patients with incontinence. It is vital for users to feel comfortable, confident, and odour-free for the duration of product wear. The innovative technology in the absorbent core of the new MoliCare design, with the strategic placement of appropriate and sufficient absorbent materials, leads to quick moisture absorption, high absorbency, and adequate leakage protection.

Another important consideration for ensuring optimum product performance, leakage protection and odour containment is an effective body-close fit (DeMarinis et al, 2018). The optimisation of leg openings in the new MoliCare Premium Pants design ensures that it fits securely and functions properly. Furthermore, the specific absorbent core design and optimised waistband resemble regular cloth underwear, contributing to a discreet fit and maximum dignity.

The ability of an absorbent product to keep the skin as dry as possible when wet is essential for both comfort and skin health (Buckley, 2019). Incorporating ADL in the core of the new design provides a dry feeling by distributing moisture to deeper layers and preventing fluid from returning to the surface of the product when pressed against skin. Moreover, it is vital to maintain an optimal skin pH to protect the skin against the irritating effects of urine and faeces (Counts et al, 2014). The modified MoliCare absorbent products provide an acidic pH surface when wet, reducing skin irritation and maintaining healthy skin.

Conclusion

This study showed that the newly redesigned MoliCare Premium Pants performed extremely well in all performance aspects. High user satisfaction levels are indicative of higher quality, specific design, and the materials used in the product. Continence products such as MoliCare encourage patients to manage their condition and allow them to lead a reasonably normal lifestyle without restricting social outings. Therefore, when chosen for appropriate customers, MoliCare Premium Pants meets users' expectations and promote the highest level of dignity and independence.

KEY POINTS

• Advanced design and innovative technology in the absorbent core of the newly developed MoliCare Premium Pants accelerate moisture absorption, promote dryness, minimise rewetting, and prevent leakage
• The acidic pH on the surface of MoliCare Premium Pants helps maintain healthy skin and prevents skin irritation
• The optimised leg openings match the body contours and improve the fit and comfort of the product
• The new design performed well in all key performance characteristics, indicating the high quality of the product

CPD reflective questions

• What are the important factors that affect the effectiveness and acceptability of absorbent incontinence products?
• What are the key innovations and developments of the newly redesigned MoliCare Premium Pants?
• How can this study help users select the most appropriate absorbent incontinence product?