Automated Screening and Education for Women With Urinary Incontinence in Primary Care.

Area of Science:

• Urology
• Women's Health
• Health Informatics

Background:

• Urinary incontinence (UI) is a prevalent condition affecting women's quality of life, yet it remains underreported and undertreated.
• Early identification and intervention are crucial for managing UI effectively.

Purpose of the Study:

• To assess the impact of an automated UI screening and Identify, Teach, and Treat (IT2) educational initiative in primary care.
• To evaluate changes in UI diagnosis rates and referrals for pelvic floor therapy and subspecialty care following IT2 implementation.

Main Methods:

• A quality improvement study utilizing electronic health record (EHR) data from 43 primary care practices.
• Interrupted time-series analysis with segmented linear regression to compare pre- and post-implementation rates of UI diagnosis and treatment.
• Inclusion of 72,009 women who presented for annual visits during the study period (January 1, 2023, to December 1, 2024).

Main Results:

• The IT2 initiative led to a significant increase in UI diagnoses, with an immediate step increase of 0.51 per 100 encounters (P=.01) and a sustained annual increase of 0.55 per 100 encounters (P=.03).
• Referrals for pelvic floor physical therapy showed a similar trend, with an initial increase of 0.38 per 100 encounters (P<.001) and an annual rate increase of 0.31 per 100 encounters (P=.001).
• Referrals to subspecialty services also increased significantly post-implementation (0.29 per 100 encounters, P<.001), while UI medication prescriptions remained unchanged.

Conclusions:

• Implementing a large-scale, automated UI screening and education program is feasible in primary care settings.
• The IT2 initiative effectively increased awareness, diagnosis, and treatment referrals for urinary incontinence among women.
• This approach holds potential for improving the management and outcomes of UI in women.