Mp54-13 a practice-based intervention to improve the care of women with urinary incontinence: protocol for a cluster randomized controlled trial

You have accessJournal of UrologyCME1 Apr 2023MP54-13 A PRACTICE-BASED INTERVENTION TO IMPROVE THE CARE OF WOMEN WITH URINARY INCONTINENCE: PROTOCOL FOR A CLUSTER RANDOMIZED CONTROLLED TRIAL Kyle Okamuro, Catherine Bresee, Isabella Dolendo, Karyn Eilber, Ramy Eskander, Tamara Grisales, Jejo Koola, Allison Mays, Carmen Mendez, Marlene Millen, Teryl Nuckols, Joshua Pevnick, David Reuben, Jennifer Singer, Ming Tai-Seale, Florin Vaida, Katherine Ward, Neil Wenger, Tajnoos Yazdany, Xi Zhu, and Jennifer Anger Kyle OkamuroKyle Okamuro More articles by this author , Catherine BreseeCatherine Bresee More articles by this author , Isabella DolendoIsabella Dolendo More articles by this author , Karyn EilberKaryn Eilber More articles by this author , Ramy EskanderRamy Eskander More articles by this author , Tamara GrisalesTamara Grisales More articles by this author , Jejo KoolaJejo Koola More articles by this author , Allison MaysAllison Mays More articles by this author , Carmen MendezCarmen Mendez More articles by this author , Marlene MillenMarlene Millen More articles by this author , Teryl NuckolsTeryl Nuckols More articles by this author , Joshua PevnickJoshua Pevnick More articles by this author , David ReubenDavid Reuben More articles by this author , Jennifer SingerJennifer Singer More articles by this author , Ming Tai-SealeMing Tai-Seale More articles by this author , Florin VaidaFlorin Vaida More articles by this author , Katherine WardKatherine Ward More articles by this author , Neil WengerNeil Wenger More articles by this author , Tajnoos YazdanyTajnoos Yazdany More articles by this author , Xi ZhuXi Zhu More articles by this author , and Jennifer AngerJennifer Anger More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003307.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urinary incontinence (UI) presents an immense human and financial burden to American women. The impact of this condition will only continue to rise as the population ages, yet primary care for UI has been inadequate to date. The primary objective of this study is to improve the quality of UI care provided to women through a controlled practice-based intervention for primary care providers. Secondary objectives include evaluating the effect of the intervention on referral rates to specialists, improving patient-centered outcomes, reducing disparities in care, and disseminating findings to a diverse population of patients and providers. METHODS: Sixty offices across 4 Southern California medical institutions will be randomized to receive a four-pronged practice-based incontinence intervention vs. routine care. The intervention involves academic detailing (physician education and individual performance feedback), clinical decision support (note templates, order sets, and best practice advisory), co-management with a dedicated advanced practice provider, and implementation of an electronic consult referral service in which inappropriate referrals are returned with recommendations. RESULTS: The quality of care, as measured by compliance with a set of 12 quality indicators, will be measured across the arms after implementation of the intervention. Patient-reported outcomes and utilization of specialists will also be compared. After the initial intervention phase, there will be a validation phase in which the control group will cross over and receive the intervention. CONCLUSIONS: The potential reach of this pragmatic practice-based trial in Southern California is vast—with 900 patients, 225 providers, 60 offices, and 4 medical institutions directly impacted. The results of the study will also contribute to the translation of patient-centered outcomes research into clinical practice, impacting women locally and nationally. Source of Funding: Funded by the Agency for Healthcare Research and Quality. Project 1U18HS028740 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e758 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kyle Okamuro More articles by this author Catherine Bresee More articles by this author Isabella Dolendo More articles by this author Karyn Eilber More articles by this author Ramy Eskander More articles by this author Tamara Grisales More articles by this author Jejo Koola More articles by this author Allison Mays More articles by this author Carmen Mendez More articles by this author Marlene Millen More articles by this author Teryl Nuckols More articles by this author Joshua Pevnick More articles by this author David Reuben More articles by this author Jennifer Singer More articles by this author Ming Tai-Seale More articles by this author Florin Vaida More articles by this author Katherine Ward More articles by this author Neil Wenger More articles by this author Tajnoos Yazdany More articles by this author Xi Zhu More articles by this author Jennifer Anger More articles by this author Expand All Advertisement PDF downloadLoading ...