GENERAL-PRACTITIONERS MANAGEMENT OF FEMALE URINARY-INCONTINENCE

Objectives - To investigate the prevailing management of female urinar y incontinence by Norwegian general practitioners (GPs), and to compar e information given by the patients with information in their medical records. Design - Incontinent women who had received reimbursement for incontinence aids or drugs were identified by the local Insurance Off ices, and a random sample was interviewed about what examinations and treatments they had received. Similar information was later collected from their GPs. Setting - The Bergen area, Norway. Subjects - Forty-ei ght GPs and 82 patients. Main outcome measures - Actions taken accordi ng to the patients and their medical records. Kappa statistics were us ed to evaluate the strength of agreement.Results - The GPs had done a gynaecological examination in 54%, a leakage provocation test in 12%, and a urinalysis in 73% of the patients. Thirty-two per cent of the wo men had been instructed in pelvic floor exercises and 13% in bladder t raining. The GPs had prescribed oestrogens for 48% of the older women (>59 years), anticholinergics for 29% of those with urge or mixed inco ntinence. Overall Kappa between the two data sources was 0.37. Conclus ion - GPs' incontinence management can be improved, especially regardi ng gynaecological examination, pelvic floor exercises, and the prescri ption of oestrogens. Retrospective chart data or patient interviews ar e unreliable data sources.