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

Eckhardt, Sarah; Takashima, Yoko; Zigman, Jessica S.; Yuan, Valerie; Álvarez, Pedro; Truong, Christina; Yazdany, Tajnoos

doi:10.1007/s00192-022-05187-5

Cited by 1 publication

(2 citation statements)

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“…Studies were published between 1990 and 2022: nine of the 31 studies were published before or in 2000, 11 between 2001 and 2010, and 11 between 2011 and 2022. Included studies assessed the practice patterns of PCPs in the United States (nine studies), the Netherlands (five), the UK (five), Norway (three), Canada (three), Australia (one), Denmark (one), France (one), Germany (one), and one pan‐European study in France, Germany, Spain and UK (Table 1 [10,27–57]).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Management of urinary incontinence in females by primary care providers: a systematic review

Charette,

Pacheco‐Brousseau,

Poitras

et al. 2023

BJU International

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ObjectiveTo describe primary care provider (PCP) practices for the assessment and management of females with urinary incontinence (UI), and appraise these practices relative to recommendations made in high‐quality clinical guidelines.MethodsStudies were searched in four databases (MEDLINE, EMBASE, CINAHL, Web of Science) from their respective inception dates to 6 March 2023. All studies describing UI evaluation and management practices used by PCPs for female patients were eligible. Two reviewers independently selected studies assessed their quality and extracted data. A narrative synthesis of included studies was performed to describe practices. Relevant evaluation and management practices were then compared to recommendations that were consistent across current high‐quality UI guidelines. Pharmacotherapy, referrals, and follow‐ups were reported descriptively only.ResultsA total of 3475 articles were retrieved and, among those, 31 were included in the review. The majority reported a poor–moderate adherence to performing a pelvic examination (reported adherence range: 23–76%; based on eight studies), abdominal examination (0–87%; three studies), pelvic floor muscle assessment (9–36%; two studies), and bladder diary (0–92%; nine studies), while there was high adherence to urine analysis (40–97%; nine studies). For the conservative management of UI, studies revealed a poor–moderate adherence to recommendations for pelvic floor muscle training (5–82%; nine studies), bladder training (2–53%; eight studies) and lifestyle interventions (1–71%; six studies). Regarding pharmacotherapy, PCPs predominantly prescribed antimuscarinics (2–46%; nine studies) and oestrogen (2–77%; seven studies). Lastly, PCPs referred those reporting UI to medical specialists (5–37%; 14 studies). Referrals were generally made <30 days after diagnosis with urologists being the most sought out professional to assess and treat UI.ConclusionThis review revealed poor–moderate adherence to clinical practice guideline recommendations. While these findings reflect high variability in reporting, the key message is that most aspects of patient care for female UI provided by PCPs needs to improve.

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Section: Resultsmentioning

confidence: 99%

“…The PCPs reported referring to medical specialists (5–37%; 14 studies) including urologists (2–27%; two studies) [30,46], gynaecologists (19–25%; two studies) [27,28,46] and urogynaecologists (10–12%; two studies) [10,56]. Referrals to medical specialists were generally made less than 30 days following UI initial assessment.…”

Section: Resultsmentioning

confidence: 99%