International urogynecology journal
September 21, 2026 · via Europe PMC
Decision Preparedness and User Experience with a Urinary Incontinence Patient Decision Aid in U.S. Primary Care.
Mou T, Brown T, Lee JY, Persell SD, Kenton K, Collins S.
AI summary — for doctors, generated from the abstract only
In U.S. primary care, fewer than a third of women using a urinary incontinence patient decision aid rated it highly recommendable, with decision preparedness and perceived usability most strongly linked to a positive experience.
What was studied
A mixed-methods secondary analysis of women 18 and older with bothersome urinary incontinence who used a specialty-developed computerized patient decision aid (PDA) in primary care, assessing likelihood-to-recommend (LTR) ratings, decision preparedness, perceived usability, and time spent in the PDA, plus qualitative free-text feedback.
Key findings
- Of 958 users who completed the PDA, 240 (25.1%) provided LTR ratings; mean LTR was 6.0 (SD 3.5), and 31% were classified as promoters
- Decision preparedness was associated with promoter status (adjusted OR 4.92, 95% CI 2.68-9.25)
- Perceived usability was also associated with promoter status (adjusted OR 1.75, 95% CI 1.22-2.60)
- Time spent in the PDA was not associated with promoter status
Clinical relevance
The findings suggest that implementing incontinence decision aids in primary care may require greater attention to decisional readiness, personalization, and integration with clinician discussion to improve the patient experience.
Who should care
Limitations
Only about a quarter of users provided a likelihood-to-recommend rating, which may limit how representative the user-experience findings are of the full user population.
Most primary-care patients using a urinary incontinence decision aid did not rate it highly, pointing to room for improving personalization and clinician integration.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Introduction and hypothesis
Patient decision aid (PDA) use for urinary incontinence (UI) in primary care settings is understudied. We evaluated users' experiences with a specialty-developed UI PDA implemented in primary care. We also examined the association of decision preparedness, perceived usability, and time spent in the PDA with user experience and summarized user feedback.
Methods
This concurrent mixed-methods secondary analysis included women aged ≥18 years with bothersome UI in primary care who accessed a computerized PDA. User experience was assessed using likelihood-to-recommend (LTR) ratings as a global user-experience measure, with ratings of 9-10 categorized as promoter status. Decision preparedness and perceived usability were assessed using validated questionnaire items reflecting decisional conflict and usability domains. Free-text feedback was summarized qualitatively to elaborate opportunities to improve user experience.
Results
Of the 958 users who completed the PDA, 240 (25.1%) provided LTR ratings; the mean LTR was 6.0 (SD 3.5), and 31% were promoters. In multivariable logistic regression adjusting for decision preparedness, perceived usability, and time spent in the PDA, both decision preparedness (aOR 4.92; 95% CI 2.68-9.25) and perceived usability (aOR 1.75; 95% CI 1.22-2.60) were associated with promoter status. Time spent in PDA was not associated with promoter status. Qualitative findings complemented quantitative results by highlighting opportunities to improve clarity, accessibility, and personalization.
Conclusions
Fewer than one-third of the respondents gave the highest likelihood-to-recommend ratings. Decision preparedness and perceived usability were associated with favorable user experience, suggesting that primary care implementation of UI PDAs may require greater attention to decisional readiness, personalization, and integration with clinician discussion.
DOI
10.1007/s00192-026-06908-w
PMID
42766159
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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