625 HEALTHCARE SEEKING IN COMMUNITY WOMEN WITH IC/BPS SYMPTOMS

Abstract

INTRODUCTION AND OBJECTIVES: The RAND Interstitial Cystitis Epidemiology (RICE) survey identified over 3000 communitydwelling women with IC/BPS symptoms. We analyzed demographic, symptomatic and quality of life (QOL) measures of women who had sought some form of medical care for their bladder symptoms (CareSeekers (CS)), and compared them with women who had never sought care for their bladder symptoms (Non-Care Seekers (NCS)). METHODS: Care-seeking was determined by a series of questions directly related to bladder-specific medical care (e.g., number of physicians seen for symptoms, etc) and by self-reported history of having received either a diagnosis or treatment for bladder symptoms. Questionnaire items focused on demographics, symptom severity and QOL indicators, including the Interstitial Cystitis Symptom and Problem Indices (ICSI, ICPI) and the Short-Form Health Survey (SF-36). RESULTS: Results are presented in the Table. The majority of the RICE cohort ( 85%) did seek care for their bladder symptoms. With the exception of insurance status, no significant demographic differences were found between CS and NCS groups. Symptom duration and severity of pain were greater in care-seekers. ICSI, ICPI and SF-36 mental and physical composite scores were similar. CS women reported more concomitant diagnoses; however, rates of fibromyalgia, chronic fatigue syndrome and panic attacks were not significantly different between CS and NCS. In the CS group, only 14.9% received a diagnosis of IC/BPS. IC/BPS diagnosis was made, on average, more than 8 years after first seeking care. CONCLUSIONS: All subjects, regardless of healthcare-seeking behavior, reported significant symptom severity and poor QOL scores. Therefore, it appears that symptom characteristics are not primarily responsible for care-seeking behavior in women with IC/BPS symptoms. Furthermore, the majority of women (85%) who presented for bladder-specific medical care did not receive a diagnosis of IC/BPS. These findings suggest that there are large numbers of symptomatic women in the community who are not diagnosed with IC/BPS, and that the reasons for this are multifactorial. IC/BPS may be much more common than previously thought.