QUALITY-OF-CARE INDICATORS FOR OVERACTIVE BLADDER SYMPTOMS

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Overactive bladder (OAB) is defined by the International Continence Society as urinary urgency, with or without urge urinary incontinence, usually with frequency and nocturia. There is a great need for quality-of- care research for women with OAB symptoms. The overall goal of this study is to develop and pilot test a set of indicators of quality of care for women with OAB, emphasizing structure, process, and outcome measures. Dr. Jennifer Anger, MD, MPH, recently completed a NRSA health services research fellowship. She studied the effect of provider variables on outcomes of incontinence surgery for women with stress urinary incontinence. Her proposed career development project and related coursework will greatly expand her research experience into the area of overactive bladder and urge urinary incontinence. The goal of this award period is for Dr. Anger to achieve complete independence as an investigator in urological health services research. She will receive extensive new training with each proposed Specific Aim: 1) To systematically review and summarize the literature on treatment of OAB, incorporating structure/process, and outcomes measures. Training: Systematic literature review 2) To conduct focus groups with patients to understand what information is most needed by women who undergo treatment for OAB symptoms. As part of these focus groups, we will also determine what outcomes matter most to patients with overactive bladder symptoms. Training: Qualitative research methods 3) To conduct interviews with physician experts in incontinence. We will determine what structure, process, and outcomes measures they consider essential to providing excellent quality care for women with OAB. Training: Expert interviews and data analysis 4) To convene an expert consensus panel to develop and rate the list of candidate indicators. Training: The RAND/UCLA Appropriateness Method 5) To pilot test our final set of proposed quality indicators to evaluate their feasibility and sensitivity while simultaneously seeking to identify variation in care between primary care clinics in two healthcare systems. Training: Chart abstraction, methodology, data analysis Relevance: Given the high prevalence and poor cure rate for overactive bladder, improving the quality of care provided to women with OAB through the development of quality-of-care indicators will lead to better patient treatment, and, ultimately, improved patient outcomes.