Brien, H., Bunting, C., & Patman, S. (2020). Referral patterns to continence physiotherapy services for patients with chronic respiratory conditions. Australian and New Zealand Continence Journal, 26 (1), 11-18.
Chronic respiratory conditions are a widely recognised risk factor for urinary incontinence and current chronic respiratory condition management guidelines state that patients should be screened for urinary incontinence and referred to continence physiotherapists for treatment. This study aimed to firstly confirm anecdotal sentiment that referrals of these patients to continence physiotherapists are low; and, secondly, to investigate barriers to the referral of these patients. Two online de novo surveys were disseminated across the metropolitan area of Perth, Western Australia: one to continence physiotherapists (Survey A) to investigate referral rates, and the other to respiratory physiotherapists, respiratory physicians and general practitioner clinics (Survey B) to investigate barriers to referral for continence management. Survey A received 30 responses and confirmed the expected low referral rate. Survey B received 41 responses, with 31% of respondents stating they “never” or “rarely” inquired about incontinence with these patients. Reported referral barriers included time constraints (50%) and a lack of prioritisation of urinary incontinence (53%). Survey findings also indicated urinary incontinence continues to carry a stigma among clinicians and patients; therefore, more should be done in order to promote an open discussion of urinary incontinence. Clinicians also require support to prioritise management of urinary incontinence with their patients. This study is one of the first to explore barriers to screening and referral in this patient group, and the issue appears to be multifactorial. Further research needs to be directed at exploring the issue further and developing strategies to address the identified barriers.
chronic respiratory conditions, urinary incontinence, referral, physiotherapy