# Improving Lower Urinary Tract Symptoms through Interdisciplinary Research and Collaboration between Primary and Specialty Care

> **NIH NIH P20** · MEDICAL COLLEGE OF WISCONSIN · 2020 · $184,049

## Abstract

RESEARCH PROJECT SUMMARY
Nearly 50% of adult women, including as many as 37% of women aged 30-50, report at least one episode of
urinary incontinence. There are several effective nonpharmacologic interventions for mild or early symptoms,
including pelvic floor exercises, which may resolve incontinence for up to 50% of patients with early disease.
For more severe cases or those who fail nonpharmacologic interventions, seven antimuscarinics (also called
anticholinergics) and one B-3 agonist (B-adrenergic) are FDA-approved, and vaginal estrogen, botulinum toxin,
urethropexy, urethral bulking, sling surgeries, and neurostimulation all show substantial benefits in some
populations of women. However, symptom burden remains high, and the field needs innovative strategies to
target effective treatments to the appropriate patients. Urinary incontinence could be better managed using
these available treatments though improved collaboration between primary and specialty care. Promising
approaches to improve chronic care should be studied in urinary incontinence, which could help with
recognition and initial treatment of stress and urgency urinary incontinence across large populations in primary
care, as well as foster the link with specialty care and improve referral patterns. Our team has built innovative
tools to allow routine electronic measurement of patient-reported outcomes using patient portals. We also have
expertise utilizing digital health and other nontraditional delivery of health interventions, with a focus on
improving equity as well. Given this background, we propose interdisciplinary team development, pilot and
feasibility work with the following aims. Aim 1) To routinely measure patient-reported urinary incontinence in a
racially diverse population of adult women in primary care. Aim 2) To pilot test a guideline-based incontinence
care pathway that integrates primary and specialty care. Aim 3) To utilize the health system's clinical data
warehouse to establish a registry in which to estimate the prevalence and equity of current incontinence health
care utilization. This will provide data about the potential eligibility for future studies among female primary care
patients and help identify the highest priority points for future intervention. We will pursue these aims in an
academic health system with over 2.8 million patient visits yearly.

## Key facts

- **NIH application ID:** 10138110
- **Project number:** 1P20DK127511-01
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** JOAN Marie NEUNER
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $184,049
- **Award type:** 1
- **Project period:** 2020-09-15 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10138110

## Citation

> US National Institutes of Health, RePORTER application 10138110, Improving Lower Urinary Tract Symptoms through Interdisciplinary Research and Collaboration between Primary and Specialty Care (1P20DK127511-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10138110. Licensed CC0.

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