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Primary care diagnostic and treatment pathways in Dutch women with urinary incontinence
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 gene...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9090412/ https://www.ncbi.nlm.nih.gov/pubmed/35179440 http://dx.doi.org/10.1080/02813432.2022.2036497 |
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author | Schreuder, Miranda C. van Merode, Nadine A. M. Oldenhof, Antal P. Groenhof, Feikje Kortekaas, Marlous F. Maagdenberg, Hedy van der Wouden, Johannes C. van der Worp, Henk Blanker, Marco H. |
author_facet | Schreuder, Miranda C. van Merode, Nadine A. M. Oldenhof, Antal P. Groenhof, Feikje Kortekaas, Marlous F. Maagdenberg, Hedy van der Wouden, Johannes C. van der Worp, Henk Blanker, Marco H. |
author_sort | Schreuder, Miranda C. |
collection | PubMed |
description | 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 POINTS: Urinary 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. |
format | Online Article Text |
id | pubmed-9090412 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-90904122022-05-11 Primary care diagnostic and treatment pathways in Dutch women with urinary incontinence Schreuder, Miranda C. van Merode, Nadine A. M. Oldenhof, Antal P. Groenhof, Feikje Kortekaas, Marlous F. Maagdenberg, Hedy van der Wouden, Johannes C. van der Worp, Henk Blanker, Marco H. Scand J Prim Health Care Original Articles 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 POINTS: Urinary 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. Taylor & Francis 2022-02-18 /pmc/articles/PMC9090412/ /pubmed/35179440 http://dx.doi.org/10.1080/02813432.2022.2036497 Text en © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Schreuder, Miranda C. van Merode, Nadine A. M. Oldenhof, Antal P. Groenhof, Feikje Kortekaas, Marlous F. Maagdenberg, Hedy van der Wouden, Johannes C. van der Worp, Henk Blanker, Marco H. Primary care diagnostic and treatment pathways in Dutch women with urinary incontinence |
title | Primary care diagnostic and treatment pathways in Dutch women with urinary incontinence |
title_full | Primary care diagnostic and treatment pathways in Dutch women with urinary incontinence |
title_fullStr | Primary care diagnostic and treatment pathways in Dutch women with urinary incontinence |
title_full_unstemmed | Primary care diagnostic and treatment pathways in Dutch women with urinary incontinence |
title_short | Primary care diagnostic and treatment pathways in Dutch women with urinary incontinence |
title_sort | primary care diagnostic and treatment pathways in dutch women with urinary incontinence |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9090412/ https://www.ncbi.nlm.nih.gov/pubmed/35179440 http://dx.doi.org/10.1080/02813432.2022.2036497 |
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