Patients with urinary incontinence (UI) often face multiple barriers to obtaining optimal care. While some of these stem from the lack of safe and effective treatments, others may be self-imposed by feelings of awkwardness, embarrassment, or social discomfort among both patients and providers.
The availability of over-the-counter absorbent products for UI may improve access to care for some patients; however, continued use can present challenges, including cost burden, dependence, and decreased motivation to seek further assessment and treatment. Despite the high visibility of incontinence supplies in pharmacies, pharmacists are largely unfamiliar with the differences between products. Consequently, UI bears the unfortunate burden of being both widely prevalent but also underrecognized and undertreated among patients of all ages. These same limitations may negatively impact the educational approaches employed to prepare students to enter the healthcare workforce.
2. Potential Solution - Educating Pharmacy Students
We created an innovative educational method for teaching pharmacy students about incontinence supplies, including absorbent products and catheters, incorporating a debrief on how to approach perceived difficult conversations on “taboo” topics. Students were provided with a variety of liners, pads, and briefs and encouraged to test the absorbent capacity of each product using small, medium, and large amounts of (strategically) colored water. Students were then given cases describing patients with various forms of incontinence and asked to recommend appropriate products matching the frequency, volume, and type of UI. Upon completion of the laboratory activity, students were asked to reflect on moments of uncomfortableness throughout the activity and to consider how their own experiences and biases may have contributed to these feelings.
Students stated they learned most from the hands-on activity with the absorbent products, which allowed them to feel materials, test absorbency, and cut products apart. For some, the laboratory session was the first time they encountered adhesive-backing for product placement in undergarments. The hands-on nature of the laboratory session empowered students to be less afraid of the products and to be able to recommend appropriate products to their patients. Student feedback on the debrief on difficult conversations showed self-awareness of what they did not know or the stigma they had felt before doing the activity, which in turn expanded their viewpoints as they recognized their implicit biases and ageism. This activity also heightened their professional sense of duty to acknowledge their biases and overcome their discomfort to be able to put the patient first.
3. Call to Action/Conclusion
This pharmacy-centric activity was subsequently remodeled to incorporate students from occupational therapy and nurse practitioner programs and could be further expanded to include other team members (e.g., medicine, physical therapy). Learning in an interprofessional environment helped students to not only learn about UI, but also what each interprofessional team member can do to help address UI. Bringing in experts from different health professions reinforces the value of interprofessional team care and allows for a deeper exploration of topics. We propose that activities directed towards breaking down stigma and improving hands-on familiarity with UI products will lead to improved care of patients with UI.
Written by:
- Emily P. Peron, Virginia Commonwealth University School of Pharmacy, Richmond, VA, United States of America
- Benjamin Van Tassell, Virginia Commonwealth University School of Pharmacy, Richmond, VA, United States of America
- Krista L. Donohoe, Virginia Commonwealth University School of Pharmacy, Richmond, VA, United States of America
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