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Erschienen in: International Urogynecology Journal 8/2022

04.05.2022 | Original Article

The impact of physician-directed and patient-directed education on screening, diagnosis, treatment, and referral patterns for urinary incontinence

verfasst von: Sarah Eckhardt, Yoko Takashima, Jessica Zigman, Valerie Yuan, Pedro Alvarez, Christina Truong, Tajnoos Yazdany

Erschienen in: International Urogynecology Journal | Ausgabe 8/2022

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Abstract

Introduction and hypothesis

The objective of this study was to evaluate the impact of patient- and physician-directed education in the primary care setting on screening, diagnosis, treatment, and referral patterns to Urogynecology for urinary incontinence (UI).

Methods

This was a prospective, multi-phase, before-and-after study conducted over a 3-year period. New female patients, 40 years and older, seen in the Internal Medicine (IM) clinic of our institution, were included. Phase 1 intervention consisted of UI lectures for IM residents. Phase 2 intervention involved placement of patient-directed posters throughout the IM clinic. Prior to phase 1, charts of new patients were reviewed as the control group to establish a baseline rate of screening, diagnosis, treatment initiation, and referrals. The same data were collected for 4 months after both phase 1 and phase 2. A washout period of 1 year occurred between phase 1 and phase 2.

Results

A total of 410 charts were reviewed and included 200 control, 92 phase 1, and 118 phase 2 patients. In the control group, 13% of patients were screened for UI. There was no significant increase in screening after phase 1 (15% vs 13%, p = 0.6); however, there was a significant increase after phase 2 (32.2% vs 13%, p < 0.001). There was no difference in treatment initiation for patients with a positive screen after either phase.

Conclusion

In our study, providing an informative lecture to an IM referral base did not improve UI screening. Alternatively, directly targeting patients through posters significantly improved screening rates in the primary care setting, demonstrating that simple interventions can improve screening for conditions that are difficult to discuss such as UI.
Literatur
3.
Zurück zum Zitat Abrams P, Andersson KE, Birder L, et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213–40.CrossRef Abrams P, Andersson KE, Birder L, et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213–40.CrossRef
4.
Zurück zum Zitat Goode PS, Burgio KL, Richter HE, et al. Incontinence in older women. JAMA. 2010;303:2172–81.CrossRef Goode PS, Burgio KL, Richter HE, et al. Incontinence in older women. JAMA. 2010;303:2172–81.CrossRef
5.
Zurück zum Zitat Farage MA, Miller KW, Berardesca E, Maibach HI. Incontinence in the aged: contact dermatitis and other cutaneous consequences. Contact Dermatitis. 2007;57(4):211–7.CrossRef Farage MA, Miller KW, Berardesca E, Maibach HI. Incontinence in the aged: contact dermatitis and other cutaneous consequences. Contact Dermatitis. 2007;57(4):211–7.CrossRef
6.
Zurück zum Zitat Centers for Disease Control and Prevention (CDC). Knowledge, attitudes, and practices of physicians regarding urinary incontinence in persons aged ~65 years—Massachusetts and Oklahoma, 1993. MMWR Mort Morb Wkly Rep. 1995;44:747–53. Centers for Disease Control and Prevention (CDC). Knowledge, attitudes, and practices of physicians regarding urinary incontinence in persons aged ~65 years—Massachusetts and Oklahoma, 1993. MMWR Mort Morb Wkly Rep. 1995;44:747–53.
7.
Zurück zum Zitat Cohen SJ, Robinson D, Dugan E, et al. Communication between older adults and their physicians about urinary incontinence. J Gerontol A Biol Sci Med Sci. 1999;54A(1):M34YM37. Cohen SJ, Robinson D, Dugan E, et al. Communication between older adults and their physicians about urinary incontinence. J Gerontol A Biol Sci Med Sci. 1999;54A(1):M34YM37.
9.
Zurück zum Zitat Jones TV, Bunner SH. Approaches to urinary incontinence in a rural population: a comparison of physician assistants, nurse practitioners, and family physicians. J Am Board Fam Pract. 1998;11(3):207Y215.CrossRef Jones TV, Bunner SH. Approaches to urinary incontinence in a rural population: a comparison of physician assistants, nurse practitioners, and family physicians. J Am Board Fam Pract. 1998;11(3):207Y215.CrossRef
10.
Zurück zum Zitat Yazdany T, Wong M, Bhatia NN. Improving resident screening and workup of urinary incontinence in an OB/GYN residency program: a randomized controlled study. Female Pelvic Med Reconstr Surg. 2011;17(5):242–5.CrossRef Yazdany T, Wong M, Bhatia NN. Improving resident screening and workup of urinary incontinence in an OB/GYN residency program: a randomized controlled study. Female Pelvic Med Reconstr Surg. 2011;17(5):242–5.CrossRef
11.
Zurück zum Zitat Lagace EA, Hansen W, Hickner JM. Prevalence and severity of urinary incontinence in ambulatory adults: an UPRNet study. J Fam Pract. 1993;36(610):614. Lagace EA, Hansen W, Hickner JM. Prevalence and severity of urinary incontinence in ambulatory adults: an UPRNet study. J Fam Pract. 1993;36(610):614.
12.
Zurück zum Zitat Bland DR, Dugan E, Coben SJ, et al. The effects of implementation of the agency for health care policy and research urinary incontinence guidelines in primary care practices. J Am Geriatr Soc. 2003;51:979–84.CrossRef Bland DR, Dugan E, Coben SJ, et al. The effects of implementation of the agency for health care policy and research urinary incontinence guidelines in primary care practices. J Am Geriatr Soc. 2003;51:979–84.CrossRef
Metadaten
Titel
The impact of physician-directed and patient-directed education on screening, diagnosis, treatment, and referral patterns for urinary incontinence
verfasst von
Sarah Eckhardt
Yoko Takashima
Jessica Zigman
Valerie Yuan
Pedro Alvarez
Christina Truong
Tajnoos Yazdany
Publikationsdatum
04.05.2022
Verlag
Springer International Publishing
Erschienen in
International Urogynecology Journal / Ausgabe 8/2022
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-022-05187-5

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