{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T12:40:25Z","timestamp":1776516025407,"version":"3.51.2"},"reference-count":30,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["KL2TR000143"],"award-info":[{"award-number":["KL2TR000143"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000092","name":"U.S. National Library of Medicine","doi-asserted-by":"publisher","award":["R01LM013396"],"award-info":[{"award-number":["R01LM013396"]}],"id":[{"id":"10.13039\/100000092","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple sclerosis (MS)\u2013related bladder dysfunction (BD) affects up to 80% of people with MS (PwMS) and substantially impacts mobility, safety, and quality of life. Pelvic Health Physical Therapy (PHPT) is an evidence-based, noninvasive treatment for MS-related BD. This retrospective study compared screening and PHPT referral rates at two time points to evaluate longitudinal changes in BD management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were analyzed from two prospective studies (2015 and 2023) enrolling adults with MS from a large subspecialty outpatient clinic. Bladder dysfunction\u2013specific patient-reported outcomes, clinic notes, treatment plans, and referral histories were assessed at baseline, 6 and 12 months. Between 2015 and 2023, many BD-targeted changes were made, including a quality improvement initiative and embedding a physical therapist in the MS-clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 2015 (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u200965) and 2023 (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u200980) cohorts were similar in demographics, MS duration, and Expanded Disability Status Scale. Bladder dysfunction prevalence was comparable (84% of 2015; 94% in 2023). However, BD-related care increased significantly in 2023: BD-specific treatment plans doubled, and PHPT referrals increased by 100%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Greater BD treatment utilization and PHPT referrals likely reflect increased awareness of BD management and expanded system capacity. Further evaluation of PHPT practices and quality improvement efforts is needed to identify the most influential contributors of increasing BD-specific treatment in PwMS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552173261443834","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T12:10:36Z","timestamp":1776341436000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Closing the referral gap: The role of a quality improvement initiative to enhance pelvic health physical therapy referrals for persons with multiple sclerosis\u2013related bladder symptoms"],"prefix":"10.1177","volume":"12","author":[{"given":"Ilana","family":"Winawer","sequence":"first","affiliation":[{"name":"University of California \u2013 San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2034-8800","authenticated-orcid":false,"given":"Riley","family":"Bove","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1561-6547","authenticated-orcid":false,"given":"Jaeleene","family":"Wijangco","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, University of California \u2013 San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7736-123X","authenticated-orcid":false,"given":"Gabby B","family":"Joseph","sequence":"additional","affiliation":[{"name":"University of California \u2013 San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5741-2717","authenticated-orcid":false,"given":"Jeannine","family":"Bradsby","sequence":"additional","affiliation":[{"name":"University of California \u2013 San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amity","family":"Eliaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Gonzalez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheantel","family":"Riehl","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, University of California \u2013 San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Keyan","sequence":"additional","affiliation":[{"name":"University of California \u2013 San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Suskind","sequence":"additional","affiliation":[{"name":"University of California \u2013 San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7689-2533","authenticated-orcid":false,"given":"Bruce AC","family":"Cree","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5121-3319","authenticated-orcid":false,"given":"Jeffrey M","family":"Gelfand","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, University of California \u2013 San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6199-5484","authenticated-orcid":false,"given":"Valerie J","family":"Block","sequence":"additional","affiliation":[{"name":"University of California \u2013 San Francisco"},{"name":"Weill Institute for Neurosciences, University of California \u2013 San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.23736\/S1973-9087.22.07217-3"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-020-00590-w"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2022.103793"},{"key":"e_1_3_3_5_2","volume-title":"Chapter 12 - Multiple sclerosis: diagnosis, differential diagnosis, and clinical presentation","author":"Gelfand JM","year":"2014","unstructured":"Gelfand JM. 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