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Problem

Urinary Incontinence (UI) affects a large number of women. More than half of women over 20 years of age reported any urinary leakage. Overall, about 30% of older women in the U.S. report moderate to severe UI, which can increase depression and work disability. What’s more, fewer than 50% of women seek care for UI symptoms. Finally, there is a significant gap between evidence-based care and actual practice. Fewer than 30% of women (> age 40) with UI report receiving any care for UI symptoms, despite available safe and effective non-surgical treatments for UI, according to a recent .

Solution

In February 2022, AHRQ launched the Improving Nonsurgical Treatment of Urinary Incontinence among Women in Primary Care (INTUIT-PC). The initiative builds on AHRQ’s EvidenceNOW Model of external support to help primary care practices implement patient-centered outcomes research (PCOR) on effective nonsurgical interventions for UI such as behavioral approaches, medications, and neuromodulation. The initiative will help close the gap between evidence and primary care practice in care for UI in women.

Program Goals

This project aims to use the EvidenceNOW Model of external support to primary care practices to help them disseminate and implement patient-centered outcomes research findings to improve nonsurgical treatments for UI among adult women in primary care practices. To achieve this goal, grantees will:

• Use evidence-based implementation strategies to increase the delivery of evidence-based care for UI among women.
• Develop or enhance mechanisms for improving linkages between primary care settings and needed supports, such as community-based resources and specialty care.
• Develop patient-centered care plans.
• Design an implementation plan that is sustainable, so that both UI treatment as well as capacity for practice improvement will be sustained.
• Evaluate the effectiveness of implementation strategies and disseminate findings.

Grantees

Five institutions from diverse states across the country were awarded 3-year grants to implement the goals to disseminate and implement the evidence in primary care practices for nonsurgical treatment of UI in women:

• University of Alabama at Birmingham
     Principal Investigator: Alayne D. Markland, D.O., M.Sc.
     Read the project profile here (PDF, 216 KB)
• University of Wisconsin – Madison
     Principal Investigator: Heidi W. Brown, M.D., M.A.S.
     Read the project profile here (PDF, 203 KB)
• University of California – San Diego
     Principal Investigator: Jennifer T. Anger, M.D., M.P.H.
     Read the project profile here (PDF, 208 KB)
• Northwestern University – Chicago
     Principal Investigator: Kimberly S. Kenton, M.D.
     Read the project profile here (PDF, 209 KB)
• University Hospitals of Cleveland
     Principal Investigator: Adonis K. Hijaz, M.D.
     Read the project profile here (PDF, 211 KB)

In addition, AHRQ has funded a contractor to design and share resources to support grantees’ success, to share resources and lessons learned through creation of a learning community for peer-to-peer learning, and to evaluate the program’s impact. This contract was awarded to RAND corporation, and the Principal Investigator is Peter Mendel, Ph.D.