Simple Question May Help Identify Women With Urinary Incontinence

Automated intervention boosts rates of diagnosis and referrals for treatment

Published on Feb. 9, 2026

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A large-scale, automated urinary incontinence (UI) screening and education program increased awareness, diagnosis, and treatment of the condition. The program, known as Identify, Teach, and Treat (IT2), asked women presenting for routine annual primary care visits a single question: "Do you have bothersome leakage of urine?" Those who answered "yes" were given the option to engage in an educational and interactive computer-based tool about UI and treatment options. The intervention led to significant increases in practice-level rates of UI diagnosis and treatment, including increased referrals for pelvic floor physical therapy and subspecialty care.

Why it matters

Urinary incontinence is dramatically underreported and undertreated despite the availability of effective conservative treatments. This study shows that a simple screening question can help identify more women with UI and connect them to appropriate care, which could have a significant impact on improving quality of life for those affected.

The details

The IT2 program was implemented at a regional academic health system in the Chicago area. Electronic health record (EHR) data were obtained for women (≥18 years of age) who presented for annual visits at 43 primary care practices before and after implementation of the initiative (Jan. 1, 2023 to Dec. 1, 2024). Among 72,009 women, 9.1% responded that they wanted to learn about treatment options. As a result, the mean clinic-level rate of UI diagnosis increased from a mean 4.2 to 5.9 per 100 encounters. The increase in diagnosis rates was accompanied by an increase in referrals for pelvic floor physical therapy and subspecialty care, but rates of new medication orders did not change.

  • The IT2 program was implemented from January 1, 2023 to December 1, 2024.
  • The study analyzed data from before and after the implementation of the IT2 program.

The players

Sarah Collins

MD, of the University of Chicago Pritzker School of Medicine, and lead researcher on the study.

Marco Blanker

MD, PhD, of the University Medical Center Groningen in the Netherlands, and author of an accompanying commentary on the study.

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What they’re saying

“To our knowledge, this is the first implementation of an automated screening and education program for UI in women in a primary care setting. Our screening rate was high and represents a significant improvement in identifying women with UI.”

— Sarah Collins, MD, lead researcher (JAMA Internal Medicine)

“The major take-home message of the study ... is that asking a single question about UI to all women before a visit can change this.”

— Marco Blanker, MD, PhD, commentator (JAMA Internal Medicine)

What’s next

The researchers noted that only 43 of the 74 health system-wide primary care practices invited to join IT2 actually participated, which may reflect the difficulty of adapting new workflows in established primary care practices. They suggested further research is needed to understand barriers to implementation and ways to increase participation in similar programs.

The takeaway

This study demonstrates that a simple, automated screening program can significantly improve the identification and treatment of urinary incontinence in women. By integrating a single screening question into routine primary care visits, healthcare providers can make substantial progress in addressing this common but undertreated condition and improving quality of life for those affected.