Results of the patient report of intermittent catheterization experience (PRICE) study

Abstract

Aims: Patient satisfaction is paramount to health-related quality of life (HR-QoL) outcomes. High quality, quantitative data from the US describing patients' actual experiences, difficulties, and HR-QoL while on an intermittent self-catheterization (ISC) regimen is very scarce. Our objective was to better understand patient practices with and attitudes towards ISC. Methods: This is a cross-sectional, multi-centered, clinical study of adult men and women performing ISC in the United States. Data collected included demographics, medical history, catheter characteristics, specific selfcatheterization habits and two validated HR-QoL questionnaires: The Intermittent Self-Catheterization Questionnaire (ISC-Q) and the Intermittent Catheterization Difficulty Questionnaire (ICDQ).Results: Two hundred participants were recruited from six sites; 70.0% were male, 73.5% were Caucasian with a median age was 51.0 years (range 19-90 years). The ISC-Q showed that the vast majority of participants reported ease with ISC (82.0% satisfaction score) had confidence in their ability to perform ISC (91.9% satisfaction score); yet, many felt self-conscious about doing so (58.3% satisfaction score) and had concerns about long-term adverse effects (58.1% satisfaction score). The ICDQ indicated little to no difficulty for most participants with all routine ISC practices. A small minority of participants reported some difficulty with a "blocking sensation" during initiation of catheterization, leg spasticity, and painful catheterization. Multivariate linear regression results are also reported. Discussion/Conclusion: Participants are confident with ISC and have little overall difficulty, which may be a product of successful education and/or catheter design. urinary tract infections (UTIs) were common (yet variable) and may contribute to the noted long-term ISC concerns. Limitations exist including various selection biases leading to concerns of external validity. Future educational

A Scoping Literature Review on Patient Education in Intermittent Catheterization

“…Patients were much better at predicting when they did not have a UTI than when a UTI was present. Roberson and colleagues15 examined patients' experiences performing ISC and reported that 34% of the 200 patients included in the study reported touching their no-touch catheter during insertion.…”

“…We identified 8 studies that examined issues relevant to ISC. Although most of the studies did not focus specifically on patient/caregiver education, they identified issues to consider when developing educational interventions including patient-reported barriers to performing ISC, 13 men's preferences in terms of catheter length, 12 patient insertion of no-touch catheters, 15 the accuracy of signs and symptoms in diagnosing UTIs and patients' ability to accurately determine whether they have a UTI, 14 and the association between upper extremity function and use of IC to manage bladder function. 15,17 With the exception of upper extremity function, each of the potential issues was examined in only 1 study, with a relatively small convenience sample, which limits generalizability of the findings.…”

“…Roberson and colleagues 15 examined patients' experiences performing ISC and reported that 34% of the 200 patients included in the study reported touching their no-touch catheter during insertion.…”

Best nonsurgical managements of acute urinary retention: what's new?

“…On subgroup analysis of 10 RCTs, CIC (OR 0.173, 95% CI 0.073-0.412) and suprapubic tube (OR 0.142, 95% CI 0.073-0.276) were associated with significantly decreased risk of UTI compared with transurethral catheterization only when catheterization duration was greater than 5 days. A recent cross-sectional, multicenter clinical study of adult patients (n ¼ 200) performing CIC for a variety of neurological and nonneurological causes showed that the vast majority of participants were comfortable with CIC (82% satisfaction) and confident in their ability to perform CIC (91.9% satisfaction) [21]. Several RCTs also compared short-term catheterization approaches in patients' satisfaction and failed to show a significant improvement of CIC over indwelling urethral catheterization [22,23].…”