TY - JOUR
T1 - Primary care diagnostic and treatment pathways in Dutch women with urinary incontinence
AU - Schreuder, Miranda C
AU - van Merode, Nadine A M
AU - Oldenhof, Antal P
AU - Groenhof, Feikje
AU - Kortekaas, Marlous F
AU - Maagdenberg, Hedy
AU - van der Wouden, Johannes C
AU - van der Worp, Henk
AU - Blanker, Marco H
N1 - Funding Information: This study was supported by the National Health Care Institute of the Netherlands under Grant 80-85300-98-18103. We thank all GPs who participated in the included networks and shared their electronic health record data, the data managers Nicole Boekema and Hanna Joosten, and the teams of the participating networks for their assistance with the data extraction and linkage procedures. Finally, we thank Dr Robert Sykes (www.doctored.org.uk) for providing editorial services. Publisher Copyright: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - OBJECTIVE: To investigate how GPs manage women with urinary incontinence (UI) in the Netherlands and to assess whether this is in line with the relevant Dutch GP guideline. Because UI has been an underreported and undertreated problem for decades despite appropriate guidelines being created for general practitioners (GPs).DESIGN: Retrospective cohort study.SETTING: Routine primary care data for 2017 in the Netherlands.SUBJECTS: We included the primary care records of women aged 18-75 years with at least one contact registered for UI, and then extracted information about baseline characteristics, diagnosis, treatment, and referral to pelvic physiotherapy or secondary care.RESULTS: In total, 374 records were included for women aged 50.3 ± 15.1 years. GPs diagnosed 31.0%, 15.2%, and 15.0% women with stress, urgency, or mixed UI, respectively; no diagnosis of type was recorded in 40.4% of women. Urinalysis was the most frequently used diagnostic test (42.5%). Education was the most common treatment, offered by 17.9% of GPs; however, no treatment or referral was reported in 15.8% of cases. As many as 28.7% and 21.7% of women were referred to pelvic physiotherapy and secondary care, respectively.CONCLUSION: Female UI is most probably not managed in line with the relevant Dutch GP guideline. It is also notable that Dutch GPs often fail to report the type of UI, to use available diagnostic approaches, and to provide appropriate education. Moreover, GPs referred to specialists too often, especially for the management of urgency UI.Key pointsUrinary incontinence (UI) has been an underreported and undertreated problem for decades. Despite various guidelines, UI often lies outside the GPs comfort zone.•According to this study: general practitioners do not treat urinary incontinence according to guidelines.•The type of incontinence is frequently not reported and diagnostic approaches are not fully used.•We believe that increased awareness will help improve treatment and avoidable suffering.
AB - OBJECTIVE: To investigate how GPs manage women with urinary incontinence (UI) in the Netherlands and to assess whether this is in line with the relevant Dutch GP guideline. Because UI has been an underreported and undertreated problem for decades despite appropriate guidelines being created for general practitioners (GPs).DESIGN: Retrospective cohort study.SETTING: Routine primary care data for 2017 in the Netherlands.SUBJECTS: We included the primary care records of women aged 18-75 years with at least one contact registered for UI, and then extracted information about baseline characteristics, diagnosis, treatment, and referral to pelvic physiotherapy or secondary care.RESULTS: In total, 374 records were included for women aged 50.3 ± 15.1 years. GPs diagnosed 31.0%, 15.2%, and 15.0% women with stress, urgency, or mixed UI, respectively; no diagnosis of type was recorded in 40.4% of women. Urinalysis was the most frequently used diagnostic test (42.5%). Education was the most common treatment, offered by 17.9% of GPs; however, no treatment or referral was reported in 15.8% of cases. As many as 28.7% and 21.7% of women were referred to pelvic physiotherapy and secondary care, respectively.CONCLUSION: Female UI is most probably not managed in line with the relevant Dutch GP guideline. It is also notable that Dutch GPs often fail to report the type of UI, to use available diagnostic approaches, and to provide appropriate education. Moreover, GPs referred to specialists too often, especially for the management of urgency UI.Key pointsUrinary incontinence (UI) has been an underreported and undertreated problem for decades. Despite various guidelines, UI often lies outside the GPs comfort zone.•According to this study: general practitioners do not treat urinary incontinence according to guidelines.•The type of incontinence is frequently not reported and diagnostic approaches are not fully used.•We believe that increased awareness will help improve treatment and avoidable suffering.
KW - General practice
KW - guideline adherence
KW - primary health care
KW - treatment
KW - urinary incontinence
KW - women
UR - http://www.scopus.com/inward/record.url?scp=85125335995&partnerID=8YFLogxK
U2 - https://doi.org/10.1080/02813432.2022.2036497
DO - https://doi.org/10.1080/02813432.2022.2036497
M3 - Article
C2 - 35179440
SN - 0281-3432
VL - 40
SP - 87
EP - 94
JO - Scandinavian journal of primary health care
JF - Scandinavian journal of primary health care
IS - 1
ER -