Communication between older adults and their physicians about urinary incontinence

Area of Science:

• Geriatrics
• Urology
• Primary Care Medicine

Background:

• Urinary incontinence (UI) is a prevalent yet underdiagnosed issue among the elderly population.
• Effective communication between older patients and physicians regarding UI is crucial for timely diagnosis and management.

Purpose of the Study:

• To investigate patient characteristics associated with communication patterns concerning urinary incontinence (UI) in older adults.
• To identify factors influencing physician-patient dialogue about UI in primary care settings.

Main Methods:

• Telephone surveys were administered to patients aged 60 and older visiting primary care providers (PCPs).
• Data collected included patient demographics, UI symptom severity, physician inquiry about UI, and patient-initiated discussions.
• The study involved 435 incontinent and 711 continent patients across 41 primary care practices.

Main Results:

• Age and gender were identified as significant predictors of incontinence.
• Physician screening rates for UI were higher in women (21%) than men (10%), though older age groups reported more symptoms.
• Younger older adults were more likely to be screened by their physicians compared to older cohorts.

Conclusions:

• Despite established guidelines, UI remains underdetected in older adults, with a notable communication gap between patients and physicians.
• Interventions are necessary to prompt physicians to screen at-risk patients and to empower patients with UI to discuss their condition.
• Addressing the "physicians don't ask, patients don't tell" phenomenon is critical for improving UI management in the elderly.