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Research ArticleOriginal Research

If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers

Heidi W. Brown, Wen Guan, Nicholas B. Schmuhl, Paul D. Smith, William E. Whitehead and Rebecca G. Rogers
The Journal of the American Board of Family Medicine September 2018, 31 (5) 774-782; DOI: https://doi.org/10.3122/jabfm.2018.05.180045
Heidi W. Brown
From the Department of Obstetrics and Gynecology (HWB, WG, NBS), and Department of Family Medicine and Community Health (PDS), University of Wisconsin-Madison School of Medicine and Public Health (UWSMPH), Madison, WI; University of North Carolina Center for Functional GI & Motility Disorders, Chapel Hill, NC (WEW); University of Texas at Austin, Dell Medical School, Austin, TX (RGR).
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Wen Guan
From the Department of Obstetrics and Gynecology (HWB, WG, NBS), and Department of Family Medicine and Community Health (PDS), University of Wisconsin-Madison School of Medicine and Public Health (UWSMPH), Madison, WI; University of North Carolina Center for Functional GI & Motility Disorders, Chapel Hill, NC (WEW); University of Texas at Austin, Dell Medical School, Austin, TX (RGR).
BA
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Nicholas B. Schmuhl
From the Department of Obstetrics and Gynecology (HWB, WG, NBS), and Department of Family Medicine and Community Health (PDS), University of Wisconsin-Madison School of Medicine and Public Health (UWSMPH), Madison, WI; University of North Carolina Center for Functional GI & Motility Disorders, Chapel Hill, NC (WEW); University of Texas at Austin, Dell Medical School, Austin, TX (RGR).
PhD
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Paul D. Smith
From the Department of Obstetrics and Gynecology (HWB, WG, NBS), and Department of Family Medicine and Community Health (PDS), University of Wisconsin-Madison School of Medicine and Public Health (UWSMPH), Madison, WI; University of North Carolina Center for Functional GI & Motility Disorders, Chapel Hill, NC (WEW); University of Texas at Austin, Dell Medical School, Austin, TX (RGR).
MD
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William E. Whitehead
From the Department of Obstetrics and Gynecology (HWB, WG, NBS), and Department of Family Medicine and Community Health (PDS), University of Wisconsin-Madison School of Medicine and Public Health (UWSMPH), Madison, WI; University of North Carolina Center for Functional GI & Motility Disorders, Chapel Hill, NC (WEW); University of Texas at Austin, Dell Medical School, Austin, TX (RGR).
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Rebecca G. Rogers
From the Department of Obstetrics and Gynecology (HWB, WG, NBS), and Department of Family Medicine and Community Health (PDS), University of Wisconsin-Madison School of Medicine and Public Health (UWSMPH), Madison, WI; University of North Carolina Center for Functional GI & Motility Disorders, Chapel Hill, NC (WEW); University of Texas at Austin, Dell Medical School, Austin, TX (RGR).
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Article Figures & Data

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    Figure 1.

    Study sample flow diagram. Describes responses to a 2015 email survey of primary care providers at a Midwest academic medical center.

  • Figure 2.
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    Figure 2.

    Barriers to screening for urinary (UI) (N = 110) and fecal incontinence (FI) (N = 139). Compares responses from primary care providers (PCPs) who screen sometimes, rarely, or never for UI (N = 110) with those who screen sometimes, rarely, or never for FI (N = 139) about barriers to or reasons for not screening in a 2015 email survey of PCPs at a Midwest academic medical center.

  • Figure 3.
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    Figure 3.

    Recommendations to better inform providers about urinary (UI) and fecal incontinence (FI) (N = 154). Compares responses from primary care providers (PCPs) about preferences for resources relate to UI and FI screening and treatment in a 2015 email survey of PCPs at a Midwest academic medical center.

Tables

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    Table 1.

    Characteristics of Respondents to an Electronic Survey of Primary Care Providers at a Midwest Academic Medical Center in 2015, Stratified by Screening for Urinary (UI) and Fecal Incontinence (FI)

    Overall Sample N = 154Screens for UI N = 113Screens for FI N = 53
    nPercentnPercentnPercent
    Provider SpecialtyP = .025P = .08
        Family medicine734757502330
        Internal medicine503330271643
        Obstetrics & gynecology25162018917
        Geriatrics646559
    Provider typeP < .001P = .017
        Attending744866583057
        Resident or fellow553628251121
        Advanced practitioner251619171223
    • View popup
    Table 2.

    Differences in Opinions and Practices Regarding Urinary (UI) and Fecal Incontinence (FI) Screening and Treatment Among Primary Care Providers at a Midwest Academic Medical Center in 2015

    UIFIP-Value
    n%n%
    I screen:
        Every/most patients4228139<.001
        Some patients71474026
        A few or none39259965
    I perceive screening to be:
        Very/extremely important74485637.04
        Somewhat important59396140
        Slightly/not at all important20133523
    Regarding treatment, I feel:
        Very/extremely informed422764<.001
        Somewhat informed84554932
        Slightly/not at all informed26179764
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The Journal of the American Board of Family     Medicine: 31 (5)
The Journal of the American Board of Family Medicine
Vol. 31, Issue 5
September-October 2018
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If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers
Heidi W. Brown, Wen Guan, Nicholas B. Schmuhl, Paul D. Smith, William E. Whitehead, Rebecca G. Rogers
The Journal of the American Board of Family Medicine Sep 2018, 31 (5) 774-782; DOI: 10.3122/jabfm.2018.05.180045

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If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers
Heidi W. Brown, Wen Guan, Nicholas B. Schmuhl, Paul D. Smith, William E. Whitehead, Rebecca G. Rogers
The Journal of the American Board of Family Medicine Sep 2018, 31 (5) 774-782; DOI: 10.3122/jabfm.2018.05.180045
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