QS118 - Patient-Reported Barriers to Completing In-Person Pelvic Floor Physical Therapy Referrals

Sunday, May 11, 2025

12:45 PM – 12:49 PM PT

Location: Room 9, Upper Level

Quick Shot Presenter(s)

Zaina S. Aloul, MBBCh

Foundation Doctor
National Health Service England (NHS England)
Newcastle Upon Tyne, England, United Kingdom

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

Kurt S. Schultz, MD (he/him/his)

Surgery Resident
Yale School of Medicine
Yale University
New Haven, Connecticut, United States

Disclosure information not submitted.
SL

Samantha M. Linhares, MD

Resident
Yale University
New Haven, Connecticut, United States

Disclosure information not submitted.
Ira L. Leeds, MD

Asst Prof of Surgery
Yale School of Medicine
New Haven, Connecticut, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no relevant relationships with ineligible companies.
Haddon J. Pantel, MD

Assistant Professor
Yale University
New Haven, Connecticut, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no relevant relationships with ineligible companies.
SM

Shilpa S. Murthy, MD MPH

Assistant Professor of Surgery
Yale School of Medicine Division of Colon and Rectal Surgery
New Haven, Connecticut, United States

Disclosure information not submitted.
VR

Vikram B. Reddy, MD, PhD, MBA

Chief of Colon and Rectal Surgery
Yale University School of Medicine
New Haven, Connecticut, United States

Disclosure information not submitted.

Senior Author(s)

Anne K. Mongiu, MD, PhD

Assistant professor, colon and rectal surgery
Yale university school of medicine, Yale New Haven Hospital
new haven, Connecticut, United States

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Zaina S. Aloul, MBBCh: This individual has no financial relationships with ineligible companies.

Ira L. Leeds, MD: This individual has no relevant relationships with ineligible companies.

Haddon J. Pantel, MD: This individual has no relevant relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Pelvic floor dysfunction is a common and debilitating condition affecting over 28 million Americans. Pelvic floor dysfunction can manifest as urologic, gynecologic, or anorectal dysfunction, which are often interconnected. Pelvic floor muscle therapy is part of first-line management for pelvic floor dysfunction. Although pelvic floor PT is efficacious in treating pelvic floor dysfunction, many patients referred for pelvic floor PT. do not attend or complete the recommended number of sessions. This study aims to identify the patient-reported barriers to successfully completing in-person pelvic floor PT, and assess willingness to use a mobile, video-based or hybrid platform for therapy.

Methods/Interventions: This was a prospective study of adult patients with pelvic floor dysfunction who were referred to a pelvic floor therapist across a statewide academic healthcare system from January 2022 to October 2024. Patients were asked to complete a structured phone survey on their perceived barriers to care and their willingness to use a mobile, video-based platform to complete pelvic floor PT. Patients were excluded if they could not complete the survey due to language difficulties, intellectual impairment, and visual/hearing deficits.

Results/Outcomes: Of 161 patients contacted, 40 (25% response rate) agreed to participate in the study. The majority (92.5%) of respondents were female, with 10% identifying as Black or African American. The three most common reasons for referral were urinary incontinence (42.5%), pelvic pain (22.5%), and fecal incontinence (17.5%). Referral sources included gynecologists (30%), urologists (30%), and colorectal/general surgeons (8%). The average time between referral and the first scheduled appointment was 10 weeks, and the average time interval between the first and last sessions was 14.5 weeks. Among patients who identified barriers to attending pelvic floor PT, the most common was that “sessions were scheduled too far in the future” (24%), followed by “too long of a distance to travel to the in-person session” (20%). Fifteen percent of participants (n=40) reported that they would attend “many more sessions” if they were video-based, while 43% would attend “a few more sessions.” Forty-eight percent of participants (n=40) reported no barriers to using a video-based platform, while 35% preferred in-person sessions. Preferences for session formats included in-person sessions (57.5%) and a hybrid or mobile video-based platform (35 %).

Conclusion/Discussion: This study identifies significant barriers to completing in-person pelvic floor PT, including long appointment wait times and distance to travel to sessions. Many patients preferred video-based or hybrid pelvic floor PT, suggesting that mobile platforms could improve access and adherence to therapy for pelvic floor dysfunction.