Trials and Tribulations of a Urinary Incontinence Screening Tool.

Importance: Women experiencing symptoms of urinary incontinence (UI) may be reluctant to discuss their symptoms with their primary care physicians (providers) due to embarrassment and stigma surrounding the condition.

Objectives: As part of a primary care quality improvement pilot intervention for UI, this study aimed to assess the success of an online screening tool in identifying bothersome urinary UI in a primary care setting. A secondary analysis sought to determine the percentage of women who discussed the condition with their providers.

Study design: Providers from a regional medical group in Southern California and their female patients 18 years of age and older were invited to participate between July 2019 and February 2020. Female patients were recruited via a screening survey. Providers were alerted by email and the patient's electronic health record when a patient screened positive.

Results: Twenty-four providers participated in the study. A total of 6,360 screening surveys were sent to female patients. Seven hundred nine (11.15%) responses were received. Three hundred two patients reported experiencing symptoms of UI, but only 166 patients chose to participate. Of the 166 participating patients, 35 (21.08%) spoke with their providers about their symptoms after they were screened.

Conclusions: Online screening for UI is feasible. The observation that only 21% of patients had conversations with their providers about their symptoms during the appointment, even after the provider was notified of the positive screen, suggests the need for better tools, such as alerts in the medical record, to enhance provider awareness of their patients' UI.