Digital ‘Identify, Teach, and Treat’ Programme Increases Detection Rates
A LARGE quality-improvement study conducted within a regional academic health system in Chicago, USA, suggests that automated screening and education in primary care may improve recognition and management of urinary incontinence (UI) among women. The findings highlight a scalable digital approach to addressing a common yet underreported condition that can significantly affect quality of life.
Urinary incontinence remains undertreated despite the availability of effective therapies, partly because patients may feel reluctant to raise symptoms and clinicians may not routinely ask about them. To address this gap, investigators implemented an “Identify, Teach, and Treat” (IT2) initiative across 43 primary care practices between January 2023 and December 2024. The programme integrated electronic health record prompts, automated patient screening, and clinician education tools into routine annual visits.
Pelvic Floor Therapy Referrals Rise, But Medication Prescribing Unchanged
A total of 72,009 women with a median age of 54 years were included in the analysis. Patients completed a brief UI screening question before or during appointments, and those reporting bothersome symptoms were offered an online educational module outlining treatment options. Clinicians received electronic alerts and pre-populated order sets to support management decisions, including referral to pelvic floor physical therapy or subspecialty services.
Overall, 9.1% of screened women reported bothersome UI and requested more information. Following implementation, clinic-level rates of new UI diagnoses increased immediately and continued to rise over time. Referrals to pelvic floor physical therapy also showed sustained growth, while subspecialty referrals increased initially but later stabilised. Notably, prescribing rates for UI medications did not change, suggesting clinicians may have prioritised conservative therapies or specialist evaluation rather than pharmacological management.
The authors describe the initiative as a feasible, system-wide strategy that leverages existing electronic workflows to promote earlier identification and treatment discussions. However, they acknowledge that, as a quality-improvement study rather than a randomised trial, the findings demonstrate associations rather than definitive causal effects.
Taken together, the results indicate that automated screening combined with targeted education may help normalise conversations about urinary incontinence in primary care and expand access to treatment pathways, offering a practical way to address gaps in women’s health screening and improve awareness of available therapies.
Reference
Collins SA et al. Automated screening and education for women with urinary incontinence in primary care. JAMA Intern Med. 2026;doi:10.1001/jamainternmed.2025.7826.
