If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers

More than half of older adults experience urinary (UI) or fecal incontinence (FI), but the majority have never discussed symptoms with health care providers. Little is known about primary care providers' (PCPs') screening for UI and FI.

We conducted a cross-sectional electronic survey of PCPs within a Midwest academic institution to ascertain and compare PCPs' beliefs, attitudes, and behaviors regarding screening and treatment for UI and FI; determine factors associated with screening for FI; and identify potential barriers to and facilitators of FI screening and treatment.

Among 154 PCPs, the screening rate for UI (75%) was more than double that for FI (35%; P < .001). PCPs believed that both UI and FI screening were important but felt better informed to treat UI (P < .001). Screening for FI was associated with UI screening (OR, 11.27; 95% CI, 4.9-26.0; P < .001); feeling informed to treat FI (OR, 10.21; 95% CI, 1.2-90.0; P = .01); screening verbally (OR, 3.9; 95% CI, 1.9-8.0; P < .001); perceiving screening as important (OR, 3.7; 95% CI, 1.8-7.4; P < .001); using the term, "accidental bowel leakage" (OR, 2.9; 95% CI, 1.2-6.7; P = .02) or "bowel control issues" (OR, 2.2; 95% CI, 1.1-4.5; P = .03); and being a resident (OR, 0.37; 95% CI, 0.16-0.82; P = .02). PCPs reported high interest in patient and provider educational materials about UI and FI.

Most PCPs screen for UI but not FI. High reported interest in educational materials, coupled with high reported rates of perceived importance of screening for UI and FI, suggests that PCPs welcome informative interventions to streamline diagnosis and treatment.

Journal of the American Board of Family Medicine : JABFM. 0000 Jan [Epub]

Heidi W Brown, Wen Guan, Nicholas B Schmuhl, Paul D Smith, William E Whitehead, Rebecca G Rogers

From the Department of Obstetrics and Gynecology (HWB, WG, NBS), and Department of Family Medicine and Community Health (PDS), University of Wisconsin-Madison School of Medicine and Public Health (UWSMPH), Madison, WI; University of North Carolina Center for Functional GI & Motility Disorders, Chapel Hill, NC (WEW); University of Texas at Austin, Dell Medical School, Austin, TX (RGR). ., From the Department of Obstetrics and Gynecology (HWB, WG, NBS), and Department of Family Medicine and Community Health (PDS), University of Wisconsin-Madison School of Medicine and Public Health (UWSMPH), Madison, WI; University of North Carolina Center for Functional GI & Motility Disorders, Chapel Hill, NC (WEW); University of Texas at Austin, Dell Medical School, Austin, TX (RGR).

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