Management and implementation of intermittent catheterization in neurogenic lower urinary tract dysfunction

Böthig, Ralf; Geng, Veronika; Kurze, Ines

doi:10.1111/ijun.12145

Cited by 6 publications

(15 citation statements)

References 19 publications

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“…Our study is consistent with other published literature describing the profile of IC users [ 11 , 12 ]. The relative prevalence of the urologic diseases represented in our dataset are similar to that reported in the guideline for management and implementation of IC [ 26 ] and other published studies [ 13 , 27 ]. Notably, several diagnoses in the group of urologic diseases stem from conditions such as SCI, MS and/or spina bifida.…”

Section: Discussionsupporting

confidence: 86%

“…Bacteria in urine are often immediately misidentified as UTI and treated with antibiotics, regardless of suitability and possible resistances [ 20 ]. Thus, antibiotic therapy should only be used in case of symptomatic or clinically relevant UTI [ 26 ]. Further education regarding the benefits and risks associated with prescribing antibiotics is important given emergence of resistant urinary pathogens as a public health concern [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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The burden of illness in initiating intermittent catheterization: an analysis of German health care claims data

et al. 2021

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Background Intermittent catheterization (IC) is a common medical technique to drain urine from the bladder when this is no longer possible by natural means. The objective of this study was to evaluate the standard of care and the burden of illness in German individuals who perform intermittent catheterization and obtain recommendations for improvement of care. Methods A descriptive study with a retrospective, longitudinal cohort design was conducted using the InGef research database from the German statutory health insurance claims data system. The study consisted of individuals with initial IC use in 2013–2015. Results Within 3 years 1100 individuals with initial IC were identified in the database (~ 19,000 in the German population). The most common IC indications were urologic diseases, spinal cord injury, Multiple Sclerosis and Spina Bifida. Urinary tract infections (UTI) were the most frequent complication occurring 1 year before index (61%) and in follow-up (year 1 60%; year 2 50%). Resource use in pre-index including hospitalizations (65%), length of stay (12.8 ± 20.0 days), physician visits (general practitioner: 15.2 ± 29.1), prescriptions of antibiotics (71%) and healthcare costs (€17,950) were high. Comorbidities, complications, and healthcare resource use were highest 1 year before index, decreasing from first to second year after index. Conclusions The data demonstrated that prior to initial catheterization, IC users experienced UTIs and high healthcare utilization. While this demonstrates a potential high burden of illness prior to initial IC, UTIs also decreased over time, suggesting that IC use may have a positive influence. The findings also showed that after the first year of initial catheterization the cost decreased. Further studies are needed to better understand the extent of the burden for IC users compared to non-IC users.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

The burden of illness in initiating intermittent catheterization: an analysis of German health care claims data

et al. 2021

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“…• German Society of Urology (DGU) [18] • Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) [19] • Neurologic Incontinence Committee (NIC) [20] • European Association of Urology (EAU) [8] • National Clinical Guideline Centre (NCGC) [21]…”

Section: Resultsmentioning

confidence: 99%

“…Appraisal of methodological quality of CPGs can identify both primary research opportunities (where there is uncertainty over treatment effectiveness owing to a lack of high-quality studies) and areas of focus for CPG developers. The strengths of this project included the use of AGREE II, a validated critical appraisal instrument for CPGs, and very good agreement among a Table 3 (continued) Agree Item DGU 2017 [18] SUFU 2017 [19] NIC 2016 [20] EAU 2015 [5,6] NCGC 2012 [16] SIGN 2012 [22] JBI 2011 [4,18] CSCM relatively large pool of raters, which enhances confidence in the AGREE II appraisal findings. While some critical appraisal tools employ weighting of scores to reflect their relative importance [25], all appraisal items are given equal weight in the AGREE II instrument.…”

Section: Discussionmentioning

confidence: 99%

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A systematic review of the content and quality of clinical practice guidelines for management of the neurogenic bladder following spinal cord injury

et al. 2019

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Introduction Neurogenic bladder following acute spinal cord injury (SCI) increases urinary tract infection (UTI) risk and affects quality of life and health system costs. Objectives This study aimed to identify, describe and evaluate quality of clinical practice guidelines (CPGs) for managing neurogenic bladder following SCI. Methods A comprehensive search covered six electronic databases (PubMed, Web of Science, Health Systems Evidence, Cochrane, CINAHL, Epistomonikos) and 12 CPG portals. Inclusion criteria were English language CPG; includes recommendations for managing neurogenic bladder in adults; all phases of care; published 2011 onwards in peer-reviewed journal/CPG portal. For eligible CPGs, key characteristics including years covered by CPG searching and number of neurogenic bladder recommendations were extracted. Quality appraisal used the AGREE II instrument. Appraiser agreement was assessed using the intraclass correlation coefficient. Results Searching yielded 4028 citations and eight relevant CPGs. Collectively the CPGs contained 304 recommendations. Over half (160) pertained to assessment, surgery or education. Most surgery recommendations were from older CPGs; more recent CPGs emphasised conservative therapy. Methodological quality across CPGs was good in the domains of 'clarity of presentation' (84% mean domain score), 'scope and purpose' (72%) and 'editorial independence' (68%). There were shortcomings in the domains of 'rigor of development' (52%) 'stakeholder involvement' (42%) and 'applicability' (33%). Conclusion CPGs for the management of neurogenic bladder following SCI are generally robust in stating their scope and clearly presenting recommendations. Only three CPGs attained domain scores over 70% pertaining to methodological rigor. Future CPGs should also focus on providing implementation / audit resources and incorporating patient perspectives.

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A Scoping Literature Review on Patient Education in Intermittent Catheterization

Quallich,

Lajiness,

Engberg

et al. 2023

Journal of Wound, Ostomy &Amp; Continence Nursing

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PURPOSE: To summarize evidence related to (1) research studies examining patient/caregiver educational interventions related to intermittent self/caregiver catheterization (ISC), (2) studies examining issues related to teaching ISC, and (3) evidence-based clinical practice guidelines addressing ISC. PROBLEM: Avoiding lower urinary tract trauma during catheter insertion, adequate frequency of catheterization, and complete emptying of the bladder are essential to prevent and reduce complications associated with ISC. Consequently, proper patient/caregiver education is essential to achieving good outcomes. METHODS: Scoping review of literature. SEARCH STRATEGY: We searched PubMed, EMBASE, and CINAHL databases, and the reference lists of background and included studies for quantitative and qualitative research studies and professional and healthcare organization–generated evidence-based clinical practice guidelines published between 2005 and September 2021. Eleven studies and 2 clinical practice guidelines met our eligibility criteria and are included in the review. FINDINGS: Research conducted in the United States examining the effectiveness of educational interventions for patients needing ongoing ISC is extremely limited. The single study identified was a small pilot feasibility study. Eight studies examining issues potentially related to patient/caregiver ISC education were identified, suggesting that catheter characteristics, patient barriers, and complications, particularly urinary tract infections, adherence, and upper extremity function, are important considerations when developing education interventions. The small number of studies and limitations in the methodologies limit the current evidence base to support patient/caregiver education about ISC. We also identified 2 evidence-based guidelines generated by European professional organizations that included recommendations related to ISC education. CONCLUSIONS: Additional research is needed to support the development of patient/caregiver educational interventions and to examine their effectiveness.

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Management and implementation of intermittent catheterization in neurogenic lower urinary tract dysfunction

Cited by 6 publications

References 19 publications

The burden of illness in initiating intermittent catheterization: an analysis of German health care claims data

The burden of illness in initiating intermittent catheterization: an analysis of German health care claims data

A systematic review of the content and quality of clinical practice guidelines for management of the neurogenic bladder following spinal cord injury

A Scoping Literature Review on Patient Education in Intermittent Catheterization

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