Work

Qualitative clinician feedback on a systematic urinary incontinence screening and patient education intervention in primary care

Year: 2026

Type: article

Abstract: Background Systematic screening for bothersome urinary incontinence (UI) is underused in primary care settings, despite the high prevalence of UI and its negative impact on quality of life. Within one academic health system a quality improvement initiative was implemented within the electronic health record (EHR) to support screening for bothersome UI in adult women with a scheduled preventive visit. Understanding clinician perspectives around this workflow may lead to improvements in its acceptability to clinicians and use in routine care.Objective To summarise qualitative clinician feedback about this UI screening initiative.Methods We conducted interviews with participating primary care clinicians. Clinicians were eligible for participation if they spent the majority of their clinical time at a clinic that had adopted the UI screening interventions in the EHR for at least 3 months. The interview guide focused on the perceived impact, usability and challenges of the screening process and workflows. Interviews lasted approximately 30 min and were audio recorded and transcribed. Thematic analysis of transcripts was conducted.Results We interviewed 22 clinicians from 10 unique clinics. Qualitative feedback revealed that clinicians valued UI screening but experienced significant time pressure and competing priorities within a routine preventive patient encounter. Clinicians were comfortable discussing UI symptoms and diagnoses. In discussing UI treatment, clinicians expressed concerns about the side effects and costs of UI medications, highlighting a preference for referring patients to pelvic floor physical therapy and subspecialty care. Clinicians had neutral or positive attitudes towards the screening intervention and provided suggestions to improve the EHR alerts and order set.Conclusions Primary care clinicians we interviewed believe UI screening is important, and this screening intervention was acceptable and may improve patient care. Underlying structural constraints on primary care are barriers to this initiative and likely will be for other quality improvement initiatives.

Source: BMJ Open Quality

DOI: 10.1136/bmjoq-2026-004311