Changes in Education and Consistency Needed in Recurrent Urinary Tract Infection Care: Patient and Expert Physician Perspectives

Abstract

Purpose: This study seeks to identify barriers to care and possible interventions to improve the treatment of recurrent urinary tract infections. Materials and Methods: Focus groups of twenty-nine women with recurrent urinary tract infections and interviews of fifteen expert physicians subspecializing in female pelvic medicine and reconstructive surgery were performed to assess the current management paradigm. The data were analyzed using the grounded theory methodology. Qualitative studies of physicians and their patients with recurrent urinary tract infection were analyzed in parallel, elucidating areas of convergent and divergent thought and allowing the investigators to identify pertinent areas for clinical improvement. Results: Qualitative analysis of the transcripts identified 3 preliminary themes: patients harbored fear; patients often received fragmented and inconsistent care for acute urinary tract infections; and patients and experts were both frustrated by limited management options and guidance for a chronic problem. Emergent themes included the need for increased patient and physician education in urinary tract infection pathophysiology and treatment and the need for a uniform multidisciplinary approach by experts and primary care physicians. Conclusions: We have identified 2 critical needs in the care of women who suffer from recurrent urinary tract infections. These deficiencies are ameliorated with clear delineation of physician roles in patient management by urologists, primary care physicians, and infectious disease specialists. Our data support the concept that a team-based approach that best uses the strengths of each specialty would dramatically improve both the outcomes and experiences of women suffering with this debilitating chronic condition.