General practitioners' management of female urinary incontinence. Medical records do not reflect patients' recall.
OBJECTIVE
To investigate the prevailing management of female urinary incontinence by Norwegian general practitioners (GPs), and to compare information given by the patients with information in their medical records.


METHODS
Incontinent women who had received reimbursement for incontinence aids or drugs were identified by the local Insurance Offices, and a random sample was interviewed about what examinations and treatments they had received. Similar information was later collected from their GPs.


METHODS
The Bergen area, Norway.


METHODS
Forty-eight GPs and 82 patients.


METHODS
Actions taken according to the patients and their medical records. Kappa statistics were used 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 women had been instructed in pelvic floor exercises and 13% in bladder training. The GPs had prescribed oestrogens for 48% of the older women (> 59 years), anticholinergics for 29% of those with urge or mixed incontinence. Overall Kappa between the two data sources was 0.37.


CONCLUSIONS
GPs' incontinence management can be improved, especially regarding gynaecological examination, pelvic floor exercises, and the prescription of oestrogens. Retrospective chart data or patient interviews are unreliable data sources.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D008485:Medical Audit; D008499:Medical Records; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000175:diagnosis / Q000628:therapy*