Understanding Barriers to Care for Urinary Incontinence Among a Contemporary Cohort of Women.

Abstract

Urinary incontinence (UI) affects half of adult women in the United States. The aim of this study was to investigate barriers for women to seek medical care for UI and to evaluate patient factors associated with delaying care. Adult women with any type and severity of UI were recruited from our clinic and from the local area via ResearchMatch to complete questionnaires on demographics, urinary symptoms, and barriers to care for UI. Multivariable logistic regression was used to assess for association between patient characteristics, symptom severity, and delaying care. A total of 1004 respondents completed the study. Median age was 47 years, and most were White, non-Hispanic (68%). A total of 514 (51%) women reported delaying seeking care for UI for any reason, citing cost of treatment (51%) as the most common reason, followed by thinking the condition was not treatable (48%) and fear (27%). Women who delayed care were more likely to report several comorbidities, had significantly worse UI severity, and had worse bladder-specific quality of life compared with those who did not delay seeking care. White race, multiparity, working full-time, and living in a rural area were associated with delaying care, medical treatment, or surgical treatment for UI. Most women in our study reported delaying seeking care, treatment, or surgery for UI. Findings from this study highlight an emphasis on patient education, telehealth, and community outreach to foster health care-seeking behavior.