PT  - JOURNAL ARTICLE
AU  - Heidi W. Brown
AU  - Wen Guan
AU  - Nicholas B. Schmuhl
AU  - Paul D. Smith
AU  - William E. Whitehead
AU  - Rebecca G. Rogers
TI  - If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers
AID  - 10.3122/jabfm.2018.05.180045
DP  - 2018 Sep 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 774--782
VI  - 31
IP  - 5
4099  - http://www.jabfm.org/content/31/5/774.short
4100  - http://www.jabfm.org/content/31/5/774.full
SO  - J Am Board Fam Med2018 Sep 01; 31
AB  - Background: More than half of older adults experience urinary (UI) or fecal incontinence (FI), but the majority have never discussed symptoms with health care providers. Little is known about primary care providers' (PCPs') screening for UI and FI.Methods: We conducted a cross-sectional electronic survey of PCPs within a Midwest academic institution to ascertain and compare PCPs' beliefs, attitudes, and behaviors regarding screening and treatment for UI and FI; determine factors associated with screening for FI; and identify potential barriers to and facilitators of FI screening and treatment.Results: Among 154 PCPs, the screening rate for UI (75%) was more than double that for FI (35%; P < .001). PCPs believed that both UI and FI screening were important but felt better informed to treat UI (P < .001). Screening for FI was associated with UI screening (OR, 11.27; 95% CI, 4.9–26.0; P < .001); feeling informed to treat FI (OR, 10.21; 95% CI, 1.2–90.0; P = .01); screening verbally (OR, 3.9; 95% CI, 1.9–8.0; P < .001); perceiving screening as important (OR, 3.7; 95% CI, 1.8–7.4; P < .001); using the term, “accidental bowel leakage” (OR, 2.9; 95% CI, 1.2–6.7; P = .02) or “bowel control issues” (OR, 2.2; 95% CI, 1.1–4.5; P = .03); and being a resident (OR, 0.37; 95% CI, 0.16–0.82; P = .02). PCPs reported high interest in patient and provider educational materials about UI and FI.Conclusions: Most PCPs screen for UI but not FI. High reported interest in educational materials, coupled with high reported rates of perceived importance of screening for UI and FI, suggests that PCPs welcome informative interventions to streamline diagnosis and treatment.