Project Summary

PCORI has identified urinary incontinence, or UI, among women as an important research topic. Although many nonsurgical treatments work well to improve UI symptoms, few studies have compared these treatments. Patients, caregivers, clinicians, and others want to learn: How do different nonsurgical treatment options compare for improving patient-centered outcomes among nonpregnant women with UI? To help answer this question, PCORI launched an initiative in 2021 on Nonsurgical Options for Women with Urinary Incontinence. The initiative funded this research project and others.

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Urinary incontinence, or UI, is a loss of bladder control that results in urine leakage. UI affects more than half of adult women in the United States and can decrease quality of life. Proven UI treatments exist. But many women don’t receive UI care from their primary care doctor that helps them manage their symptoms effectively.

In this study, the research team is comparing two ways to help primary care doctors manage UI care:

  • Electronic management. Specialists review electronic health records, or EHRs, of patients who were referred for specialized treatment. The specialists recommend additional primary UI care if needed before patients receive specialized treatment.
  • Advanced practice provider, or APP, management. A physician assistant or nurse practitioner works with the primary care doctor, providing UI care, education, and help with self-care to patients via telehealth. Telehealth is a way to provide care to patients remotely using phone, video, or monitoring devices that can help manage care.

Who can this research help?

Results may help clinics when considering ways to manage UI as part of primary care.

What is the research team doing?

The research team is recruiting 60 primary care clinics in Southern California. The team is assigning clinics by chance to provide either electronic or APP management for UI.

The research team is reviewing EHRs for 900 women with UI who attend the clinics. The team wants to see how well the clinics manage UI care.

At the start of the study and again six months later, the research team is surveying patients about:

  • UI symptoms
  • Quality of Life
  • Improvement in UI
  • Patient knowledge of UI
  • How much patients felt they could take part in their healthcare decisions

The research team is looking to see if these outcomes differ based on features of the clinics such as their location or how experienced their doctors are. The team also wants to know if outcomes differ by patient traits such as their preferred language and type of UI.

Patients with UI, doctors, and patient advocates are helping to plan this study.

Research methods at a glance

Design Element Description
Design Cluster randomized controlled trial
Population 900 women with UI
  • Electronic co-management
  • APP co-management

Primary: quality of UI care

Secondary: UI symptoms, quality of life, improvement in UI, patient knowledge of UI, shared decision making

Timeframe Timeframe Length of follow-up for collecting data on primary outcomes. View Glossary 6-month follow-up for primary outcome

Project Information

Jennifer Anger, MD, MPH
Jonathan Bergman, MD
University of California San Diego
Comparative Efficacy of Advanced Practice Provider vs. Electronic Co-Management in a Diverse Population of Aging Women with Urinary Incontinence

Key Dates

March 2022
October 2028


Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: January 24, 2024