Shared decision-making across the urinary incontinence care continuum: implications for patient-centered care

Area of Science:

• Urology
• Healthcare Decision Science
• Patient-Centered Care

Background:

• Urinary incontinence (UI) affects many women, yet care access remains a challenge.
• Navigating UI care involves multiple personalized decisions, highlighting the need for patient-centered approaches.

Purpose of the Study:

• To review how shared decision-making and decision science can enhance patient-centered UI care delivery.
• To examine decision-making complexities across the UI care continuum.

Main Methods:

• Literature review examining shared decision-making and decision science in UI care.
• Analysis of patient decision-making stages, barriers, and existing decision support tools.

Main Results:

• Patients face complex decisions regarding symptom reporting, seeking care, and treatment initiation/completion.
• Barriers include limited knowledge, stigma, normalization, treatment concerns, and system-level issues.
• Current decision aids focus on treatment selection and show promise but require more rigorous evaluation.

Conclusions:

• Patient-centered UI care must address decision needs throughout the care continuum.
• Future research needs greater rigor, focus on understudied phases, clinical outcomes, and implementation strategies.