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Managing children with daytime urinary incontinence: a survey of Dutch general practitioners. | LitMetric

Managing children with daytime urinary incontinence: a survey of Dutch general practitioners.

Eur J Gen Pract

Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.

Published: December 2023

AI Article Synopsis

  • - In the Netherlands, general practitioners (GPs) lack clear guidelines for managing daytime urinary incontinence (UI) in children, leading to inconsistent referral practices without specific direction.
  • - A survey showed that most GPs perform basic assessments like urine tests before referring children, often to a paediatrician, with lifestyle advice being the main form of initial treatment.
  • - Many GPs feel unprepared to handle daytime UI on their own and expressed a strong desire for standardized clinical practice guidelines to guide their treatment and referral decisions.

Article Abstract

Background: In the Netherlands, parents of children with daytime urinary incontinence (UI) first consult general practitioners (GPs). However, GPs need more specific guidelines for daytime UI management, resulting in care and referral decisions being made without clear guidance.

Objectives: We aimed to identify Dutch GP considerations when treating and referring a child with daytime UI.

Methods: We invited GPs who referred at least one child aged 4-18 years with daytime UI to secondary care. They were asked to complete a questionnaire about the referred child and the management of daytime UI in general.

Results: Of 244 distributed questionnaires, 118 (48.4%) were returned by 94 GPs. Most reported taking a history and performing basic diagnostic tests like urine tests (61.0%) and physical examinations (49.2%) before referral. Treatment mostly involved lifestyle advice, with only 17.8% starting medication. Referrals were usually at the explicit wish of the child/parent (44.9%) or because of symptom persistence despite treatment (39.0%). GPs usually referred children to a paediatrician ( = 99, 83.9%), only referring to a urologist in specific situations. Almost half (41.4%) of the GPs did not feel competent to treat children with daytime UI and more than half (55.7%) wanted a clinical practice guideline. In the discussion, we explore the generalisability of our findings to other countries.

Conclusion: GPs usually refer children with daytime UI to a paediatrician after a basic diagnostic assessment, usually without offering treatment. Parental or child demand is the primary stimulus for referral.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10132240PMC
http://dx.doi.org/10.1080/13814788.2022.2149731DOI Listing

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