Perspectives from the Field: Advancing Urinary Incontinence Management in Primary Care
Interviews were conducted with three of the five MUI grantee teams to learn more about the implementation of interventions in primary care for the nonsurgical treatment of urinary incontinence (UI) in women. In these interviews, project leaders recount their experiences working with primary care practices to implement UI screening and treatment. Several themes emerged across the interviews, including working within the current constraints of primary care providers, addressing stigma of urinary incontinence with patients, and ensuring that interventions are tailored appropriately for their medical system settings. Each team provides actionable advice for primary care providers and practices on steps, both small and large, that can be taken to address UI among patients, to ultimately improve patient quality of life.
The interviews below describe unique lessons from each team’s interventions.
The Identify, Teach and Treat (IT2) project is implementing screening for urinary incontinence at the time of pre-visit automated appointment confirmation in women presenting to primary care practice (PCP) annual visits. IT2 is being implemented in Northwestern Medicine, an integrated healthcare system. Women who screen positive for UI are directed to a digital patient education and shared decision-making tool that populates patient treatment preferences into the patient chart for clinician review.
The Optimizing Primary Care Tools for Incontinence Management (OPTIMA) project, led by University of California San Diego, is implementing a four-pronged intervention to improve the quality of care for women with UI. This intervention included academic detailing, clinical decision support, Advanced Practice Provider (APP) co-management, and electronic referral. OPTIMA is working with four large Southern California health systems, including a safety-net system with a large number of Spanish-speaking women.
The Wisconsin Improving Nonsurgical Treatment of Urinary Incontinence among Women in Primary Care (WI-INTUIT) team from the University of Wisconsin Madison is comparing streamlined practice facilitation (SPF) and SPF in combination with partnership building. WI-INTUIT is working across a wide variety of primary care practices across the state.
