Sophia Miryam Schüssler-Fiorenza Rose1,2, Ronald E Gangnon3,4, Betty Chewning5, Arnold Wald6. 1. 1 Spinal Cord Injury Service, Veteran Affairs Palo Alto Health Care System , Palo Alto, California. 2. 2 Department of Neurosurgery, Stanford University , Stanford, California. 3. 3 Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin. 4. 4 Department of Biostatistics and Medical Informatics, School of Pharmacy, University of Wisconsin , Madison, Wisconsin. 5. 5 Department of Sonderegger Research Center, School of Pharmacy, University of Wisconsin , Madison, Wisconsin. 6. 6 Department of Medicine, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.
Abstract
BACKGROUND: A minority of women with urinary incontinence (UI) and even fewer with fecal incontinence (FI) report having discussed it with a health care provider in the past year. Thus our aim was to evaluate whether the use of an electronic pelvic floor assessment questionnaire (ePAQ-PF) improves communication about incontinence in primary care. METHODS:Women 40 years and older who were scheduled for an annual wellness physical at an internal medicine clinic between August 2007 and August 2008 were randomized to complete the ePAQ-PF prior to (n = 145) or after (n = 139) their visit. Clinicians of women in the intervention group received the ePAQ-PF report prior to the visit. Outcome measures from clinic note abstraction included mention of UI (primary) and FI. Participant-reported outcome measures included discussion of UI and FI and initiator of discussion. RESULTS: Discussions of UI was more common in the intervention group than the control group: (27% vs. 19%; odds ratio [OR], 1.6 95% confidence interval [95%CI] 0.9-2.8, particularly for women over 60 (33% vs. 12%; OR 3.8, 95%CI 1.2-11.8) and for women with UI (42% vs. 25%; OR 2.2, 95%CI 1.1-4.1). The intervention primarily led to an increase in clinician-initiated UI discussions which were more common in the intervention group (18% vs. 4%, OR 4.8, 95%CI 1.9-12.0) Participants in the intervention group more frequently reported discussion of FI (14% vs. 6%; OR 2.5, 95%CI 1.1-6.0) which was clinician initiated in over half the cases (9% vs. 3%; OR 3.5, 95%CI 1.1-11.0). CONCLUSIONS: Use of the ePAQ-PF prior to clinic visits increases discussion of UI and FI, particularly clinician-initiated discussion. These findings suggest that such instruments may increase the detection and treatment of this often "silent" affliction.
RCT Entities:
BACKGROUND: A minority of women with urinary incontinence (UI) and even fewer with fecal incontinence (FI) report having discussed it with a health care provider in the past year. Thus our aim was to evaluate whether the use of an electronic pelvic floor assessment questionnaire (ePAQ-PF) improves communication about incontinence in primary care. METHODS:Women 40 years and older who were scheduled for an annual wellness physical at an internal medicine clinic between August 2007 and August 2008 were randomized to complete the ePAQ-PF prior to (n = 145) or after (n = 139) their visit. Clinicians of women in the intervention group received the ePAQ-PF report prior to the visit. Outcome measures from clinic note abstraction included mention of UI (primary) and FI. Participant-reported outcome measures included discussion of UI and FI and initiator of discussion. RESULTS: Discussions of UI was more common in the intervention group than the control group: (27% vs. 19%; odds ratio [OR], 1.6 95% confidence interval [95%CI] 0.9-2.8, particularly for women over 60 (33% vs. 12%; OR 3.8, 95%CI 1.2-11.8) and for women with UI (42% vs. 25%; OR 2.2, 95%CI 1.1-4.1). The intervention primarily led to an increase in clinician-initiated UI discussions which were more common in the intervention group (18% vs. 4%, OR 4.8, 95%CI 1.9-12.0) Participants in the intervention group more frequently reported discussion of FI (14% vs. 6%; OR 2.5, 95%CI 1.1-6.0) which was clinician initiated in over half the cases (9% vs. 3%; OR 3.5, 95%CI 1.1-11.0). CONCLUSIONS: Use of the ePAQ-PF prior to clinic visits increases discussion of UI and FI, particularly clinician-initiated discussion. These findings suggest that such instruments may increase the detection and treatment of this often "silent" affliction.
Authors: Adil E Bharucha; Gena Dunivan; Patricia S Goode; Emily S Lukacz; Alayne D Markland; Catherine A Matthews; Louise Mott; Rebecca G Rogers; Alan R Zinsmeister; William E Whitehead; Satish S C Rao; Frank A Hamilton Journal: Am J Gastroenterol Date: 2014-12-23 Impact factor: 10.864
Authors: Els Visser; Geertruida H de Bock; Embert J Messelink; Aaltje J Schram; Boudewijn J Kollen; Sacha la Bastide-van Gemert; Edwin R van den Heuvel; Marjolein Y Berger; Janny H Dekker Journal: Maturitas Date: 2014-12-02 Impact factor: 4.342
Authors: Thomas G Gray; Rosanna Sneyd; Kaia Scurr; Georgina L Jones; David Iles; Swati Jha; Stephen C Radley Journal: Int Urogynecol J Date: 2019-03-29 Impact factor: 2.894
Authors: Patrick Campbell; Weiguang Li; John Money-Taylor; Joanna Davies; Thomas Gray; Stephen Radley Journal: Int Urogynecol J Date: 2016-08-01 Impact factor: 2.894
Authors: Jenna M Norton; Jennifer L Dodson; Diane K Newman; Rebecca G Rogers; Andrea D Fairman; Helen L Coons; Robert A Star; Tamara G Bavendam Journal: Int Urogynecol J Date: 2017-07-03 Impact factor: 2.894
Authors: Heidi W Brown; Wen Guan; Nicholas B Schmuhl; Paul D Smith; William E Whitehead; Rebecca G Rogers Journal: J Am Board Fam Med Date: 2018 Sep-Oct Impact factor: 2.657
Authors: Georgina Jones; Victoria Brennan; Richard Jacques; Hilary Wood; Simon Dixon; Stephen Radley Journal: PLoS One Date: 2018-01-18 Impact factor: 3.240