Management of stress urinary incontinence associated with perimenopause

Increasing numbers of independent physiotherapist prescribers are being employed in many areas of clinical practice. Most are in musculoskeletal services, but this is extending into primary care and urgent treatment settings (Robertson, 2022).

The role of the pelvic health physiotherapist independent prescriber is one such specialist service that aims to expediate access to treatment and improve service user satisfaction. Pelvic health physiotherapy is recommended as the first-line treatment for patients with lower urinary tract symptoms and pelvic floor dysfunction (National Institute for Health and Care Excellence (NICE), 2019; 2021a, b). The service receives referrals from varied sources, including GPs, obstetrics and gynaecology, bladder and bowel specialists, midwives and self-referrals. However, for some referrals physiotherapy treatment alone will not fully alleviate the presenting condition and medication management is required.

Physiotherapists were initially given the rights to train as supplementary prescribers in 2005 and this was further extended to independent prescribing in 2013. Currently, physiotherapist independent prescribers can prescribe any medicine for any medical condition, including ‘off-label’ medicines but not unlicensed medicines, and they are subject to a specific list of named controlled drugs only. Independent prescribing enables the physiotherapist to safely prescribe medication, allowing a smoother, more efficient patient journey with quicker access to medicines (Chartered Society of Physiotherapy (CSP), 2018). This service aligns with the key principles of realistic medicine, ensuring safe, evidence-based and cost-effective care (Fenning et al, 2019).