Better together: multidisciplinary approach improves adherence to pelvic floor physical therapy

Int Urogynecol J. 2020 May;31(5):887-893. doi: 10.1007/s00192-019-04090-w. Epub 2019 Aug 28.

Abstract

Introduction and hypothesis: To determine whether consultation with pelvic floor physical therapy (PFPT) at the time of initial urogynecologic evaluation increases adherence to PFPT and to identify factors associated with PFPT attendance and completion.

Methods: We performed a retrospective chart review of all patients evaluated for new urogynecology consultation at our institution in a 1-year period, abstracting data about demographics, diagnoses, and PFPT referral, attendance, and completion. Descriptive analyses compared patients who were referred to, attended, and completed PFPT, stratified by whether they saw PFPT the same day as their initial urogynecologic consultation. Logistic regression identified factors associated with PFPT attendance, completion, and referral.

Results: PFPT referral was made for 35% (335/958), of whom 67% attended and 42% completed PFPT. Patients who saw PFPT the same day as their first urogynecology visit were significantly more likely to attend PFPT than those who did not (91% vs. 61%, p < 0.001), but completion rates did not differ (49% vs. 41%, p = 0.15). PFPT attendance was higher among women who saw a PFPT the same day as their initial urogynecology appointment (p < 0.001) and among those aged ≥ 65 years (p = 0.015). Age ≥ 65 years and white, non-Hispanic race/ethnicity were associated with PFPT completion. Patients with a diagnosis of pelvic organ prolapse or urinary incontinence and those seen in multidisciplinary clinic were more likely to be referred to PFPT.

Conclusions: PFPT consultation at the time of initial urogynecologic evaluation improves attendance of initial PFPT appointment, but does not improve completion rates.

Keywords: Pelvic floor disorders; Pelvic organ prolapse; Physical therapy modalities; Urinary incontinence.

MeSH terms

  • Aged
  • Female
  • Humans
  • Pelvic Floor
  • Pelvic Floor Disorders* / therapy
  • Pelvic Organ Prolapse* / therapy
  • Physical Therapy Modalities
  • Retrospective Studies
  • Urinary Incontinence* / therapy