Identifying women’s preferences for treatment of urinary tract infection: a discrete choice experiment

Abstract

ObjectiveTo identify the preferences of women regarding management of urinary tract infections (UTIs).DesignA discrete choice experiment of the preferences for certain treatment attributes was conducted by survey. Attributes included treatment duration, time to complaint resolution, complication risk, side effect risk and contribution to antimicrobial resistance.SettingGeneral population in the Netherlands, recruited via social media.ParticipantsWomen aged 18 years or older.Primary and secondary outcome measuresThe primary outcome was the relative importance of the attributes for treatment choice, using a conditional logit model. The secondary outcome was the heterogeneity in these preferences.ResultsThe discrete choice experiment was completed by 833 women. Most attributes were important to decisions for UTI treatment. Women were willing to accept management with, for example, a higher chance of complications or longer time to resolution, if it could help avoid antimicrobial resistance. However, there was heterogeneity in the preferences. Women who had one previous UTI had a stronger preference for faster symptom resolution compared with those who had no previous UTI. Younger women also preferred faster symptom resolution. Finally, women with a low or middle education level gave less importance to preventing antimicrobial resistance than women with a high education level.ConclusionsThe current study indicated that a considerable part of women valued alternatives to antimicrobial treatment and were prepared to tolerate management that was less optimal in certain respects to avoid antimicrobial treatment.

Shared decision making for women with uncomplicated Cystitis in Primary Care in the Netherlands: a qualitative interview study

“…In our study, women appreciated it if their GP made an effort to investigate possible causes and discuss different treatment options, including prophylactic strategies, for cystitis. These findings are similar to those of other qualitative studies that investigated optimizing antibiotic stewardship regarding UTIs and the need for SDM in the treatment of UTIs [ 29 – 31 ]. It is therefore indicated that it is useful to provide women with proper consultations, in which healthcare workers listen to women’s experiences and discuss different treatment options with them.…”

Young Women’s Attitudes and Behaviors in Treatment and Prevention of UTIs: Are Biomedical Students at an Advantage?

“…Furthermore, findings from recent research have suggested that a considerable proportion of women are willing to tolerate less than optimal management in certain respects in order to avoid antimicrobial treatment for UTIs. These results indicate that there is a preference to avoid antimicrobial treatment and that resistance is strongest among women with a higher level of education, while younger women or those who had only experienced one previous UTI placed greater emphasis on quicker resolution of complaints [27].…”

Patients’ Experiences, Expectations, Motivations, and Perspectives around Urinary Tract Infection Care in General Practice: A Qualitative Interview Study

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