Making the Benefits of Research Real for People: AHRQ’s Implementation Initiative Addresses Urinary Incontinence

Many women in America suffer from urinary incontinence, but few receive evidence-based care. The consequences of untreated urinary incontinence are lower quality of life with higher morbidity and mortality.  Yet we know what helps. 

A recent systematic review commissioned by the Patient-Centered Outcomes Research Institute (PCORI), and conducted by AHRQ‘s Evidence-based Practice Research program, conclusively demonstrated that there are many effective nonsurgical approaches for managing urinary incontinence. In a stakeholder meeting, co-sponsored by PCORI and AHRQ, patient representatives, professional societies, health systems, and Federal partners all stressed the importance of improving care for this common, but often ignored, condition.

Nonsurgical therapies for urinary incontinence can improve or cure symptoms, and are safe, even in older women and those with multiple chronic conditions. There are many reasons why women go untreated for this “Don’t Ask, Don’t Tell” condition. Many women are unaware of effective therapies and may be embarrassed to report symptoms. Clinicians may be unaware of the latest evidence, and often don’t have the resources or systems, such as health educators or access to specialty care, in place to effectively manage this condition.

The time to address the problem is now. Clinicians, researchers, public health advocates, and others must work together to help women get treated for urinary incontinence, and to avoid the costs and harms of untreated urinary incontinence in the future.  This is where AHRQ comes in. A core part of AHRQ’s mission is to catalyze the implementation of evidence into practice.

Because people with health concerns often turn first to their primary care physicians, AHRQ has released a new Funding Opportunity Announcement to develop and implement interventions to increase screening and treatment for women with urinary incontinence in primary care. AHRQ will allocate up to $15 million in 3-year grants to five non-profit organizations.

Grantees will draw upon community-based resources, use collaborative or stepped-care approaches to engage specialty care when needed, and focus on changes at both the clinical practice and health system level.  This type of multi-level quality improvement approach is what distinguishes the type of research and implementation work AHRQ conducts.

Our expectations are high that this effort will improve the lives of women. The negative impacts of ongoing urinary incontinence—on patients and their families—can be costly. These consequences are powerful incentives for us to work together and increase the use of evidence to tackle this urgent public health concern.

Jill Huppert is a medical officer in AHRQ’s Center for Evidence and Practice Improvement. Arlene Bierman is director of the Center for Evidence and Practice Improvement.

Note for Researchers and Implementers: The deadline for submissions is March 24. Potential applicants are encouraged to submit a letter of intent. A technical assistance call on Feb. 25 from 3 to 4 p.m., ET, will provide a summary of the initiative and address frequently asked questions Additional information on submitting a letter of intent, registering for the technical assistance call and submitting questions in advance of the call can be found in the funding announcement.

For questions, please email UI_grant@ahrq.hhs.gov.

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