Introduction: 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.
