Improvement needed in managing UTI in patients with neurogenic bladder, says study

Expansion of caregiver involvement, enhancement of patient-provider communication, and targeting providers and care settings that lack familiarity with neurogenic bladder (NB) could improve urinary tract infection (UTI) management in this population, according to a study published online Nov. 1 in PLOS ONE.

Margaret A. Fitzpatrick, M.D., from Rocky Mountain Regional VA Medical Center in Aurora, Colorado, and colleagues recruited adults with NB due to spinal cord injury/disorder (SCI/D) or multiple sclerosis (MS) to participate in 11 virtual focus groups. A total of 23 veterans (78 percent with SCI/D; 18.5 percent with MS) were included between May 2021 and May 2022.

The researchers found that three major themes reflected participants' perspectives, experiences, and beliefs about UTI: influence of caregivers; influence of health care environment and provider characteristics; and barriers and facilitators to care.

Caregivers promoted care-seeking behavior, enabled care in the home, and improved participant self-efficacy for understanding educational material. Poor perceptions of providers who were not knowledgeable about NB or communicated ineffectively were reported. Self-efficacy to follow provider recommendations was improved by good relationships with providers who knew the participants well.

"Interventions to enhance patient-centeredness of UTI care for these individuals could focus on expanding in-home care by trusted, knowledgeable providers and improving patient-provider communication," the authors write.

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