Outcomes of Urinary Incontinence Treatment in Primary Care: APP Co-Management and Electronic Consult

Launched by UNIVERSITY OF CALIFORNIA, SAN DIEGO · Sep 8, 2023

Keywords

ClinConnect Summary

This trial is testing two ways to deliver non-surgical care for urinary incontinence (UI) in primary care settings. It randomizes about 1,200 adult women with UI to either (a) an electronic consult (e-consult) approach, where specialists review referrals and give recommendations remotely, or (b) Advanced Practice Provider (APP) co-management, where trained APPs lead patient education and self-management through telemedicine. Both groups also receive standard physician education and decision-support tools. The study aims to see which method best improves the quality of care and patient-reported outcomes related to UI.

Eligible participants are women 18 years or older who speak English or Spanish, have UI, and are willing to participate; some may be excluded if they are pregnant, have memory or psychiatric concerns, or are deemed ineligible by their primary care provider. The trial is being conducted at three sites (UC San Diego, UCLA, and the University of Kansas) and includes baseline and follow-up assessments at 3 and 6 months to measure symptoms, quality of life, decision-making, and satisfaction. Results are not yet available, as the study is still enrolling and expected to continue through 2027.

Gender

FEMALE

Eligibility criteria

• Inclusion Criteria of Primary Care Physicians:
• • - Primary care physician belonging to a recruited office among one of three participating sites: UCSD, UCLA, KUMC
• Inclusion Criteria of Patients:
• • Age \>18 y/o
• • English or Spanish fluency
• • Female
• • Answers \"yes\" to incontinence screening tool and agrees to participate
• Exclusion Criteria of Primary Care Physicians:
• • Non-primary care specialty
• • Does not belong to one of the participating offices
• Exclusion Criteria of Patients:
• • Age \<18 y/o
• • Answers \"no\" to incontinence screening tool and/or does not agree to participate
• • Primary care provider (who reviews a list of patients that screen positive) deems patient ineligible due to pregnant, severe memory impairment, or psychiatric history preventing participation