Mazloomdoost Donna, Westermann Lauren B, Crisp Catrina C, Oakley Susan H, Kleeman Steven D, Pauls Rachel N
Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, TriHealth/Good Samaritan Hospital, 3219 Clifton Ave, Cincinnati, OH, 45220, USA.
Int Urogynecol J. 2017 Mar;28(3):447-453. doi: 10.1007/s00192-016-3134-1. Epub 2016 Oct 28.
Understanding barriers to seeking care for pelvic floor disorders is necessary. We sought to assess familiarity with pelvic floor disorders, as well as identify screening and referral patterns among primary care providers.
This Institutional Review Board approved study was distributed through a secure online server (SurveyMonkey®). Primary care providers within a large healthcare system were invited to participate in a 14-question survey regarding the prevalence, diagnosis, and treatment of urinary incontinence (UI), overactive bladder (OAB) syndrome, and pelvic organ prolapse (POP). Demographic information was collected. Descriptive statistics and associations were calculated.
A total of 360 emails were delivered, 108 responded (response rate 30.0 %). Respondents were evenly distributed with respect to age and years in practice. Providers correctly estimated the prevalence of UI and OAB, and most reported treating these conditions themselves (92.6 % and 88.9 %, respectively). If treatment failed, however, referral was most often (68.1 %) to urology. The majority reported not screening for POP, and 50.9 % believed the prevalence to be rare. Referrals for POP were most often (61.1 %) to urogynecology. Male providers were less likely to screen for POP than female providers (p < 0.001). Only a minority (35.2 %) described being 'very familiar' with urogynecology, and 19.4 % were unaware of such providers within the system.
Primary care providers within a large healthcare system were more familiar with UI and OAB than POP, often underestimating the prevalence of POP. Nearly one-fifth were unaware of urogynecologists within their system. Educational outreach regarding pelvic floor disorders and the urogynecology specialty would likely improve patient access to care.
了解盆底功能障碍患者寻求治疗的障碍很有必要。我们试图评估对盆底功能障碍的认知程度,并确定初级保健提供者的筛查和转诊模式。
这项经机构审查委员会批准的研究通过一个安全的在线服务器(SurveyMonkey®)进行分发。邀请大型医疗系统中的初级保健提供者参与一项包含14个问题的关于尿失禁(UI)、膀胱过度活动症(OAB)综合征和盆腔器官脱垂(POP)的患病率、诊断和治疗的调查。收集了人口统计学信息。计算了描述性统计数据和相关性。
共发送了360封电子邮件,108人回复(回复率30.0%)。受访者在年龄和从业年限方面分布均匀。提供者正确估计了UI和OAB的患病率,且大多数报告自己治疗这些疾病(分别为92.6%和88.9%)。然而,如果治疗失败,转诊最常(68.1%)至泌尿外科。大多数人报告未对POP进行筛查,50.9%的人认为其患病率很低。POP的转诊最常(61.1%)至女性泌尿外科。男性提供者比女性提供者筛查POP的可能性更小(p < 0.001)。只有少数(35.2%)表示对女性泌尿外科“非常熟悉”,19.4%的人不知道系统内有此类提供者。
大型医疗系统中的初级保健提供者对UI和OAB比对POP更熟悉,常常低估POP的患病率。近五分之一的人不知道系统内有女性泌尿外科医生。关于盆底功能障碍和女性泌尿外科专业的教育推广可能会改善患者获得治疗的机会。