Intermittent self-catheterization training and effects on treatment adherence and infection.
Luisa DE Palma, Raffaele Balsamo, Annarita Cicalese and 7 others
PMID 37750862WHAT IT FOUND
Whether patients learned self-catheterization immediately or a day later did not change adherence or complications over 12 months.
However, patients who skipped or added catheterizations had significantly more urinary tract infections, and those with multiple sclerosis had higher infection rates and poorer technique.
Key findings
01Training patients on clean intermittent self-catheterization immediately after prescription versus one or two days later resulted in no significant difference in short-term or long-term adherence to the prescribed schedule.
02Patients who deviated from the prescribed number of daily catheterizations had significantly higher rates of urinary tract infections at both 6 and 12 months compared to those who followed the schedule exactly.
03Patients with multiple sclerosis had significantly higher rates of urinary tract infections at 12 months and performed the catheterization procedure correctly significantly less often than patients with spinal cord injury or other neurological disorders.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was non-randomized, meaning the assignment to early or late training was based on clinic availability rather than random chance, which introduces potential selection bias. Adherence and satisfaction were not measured using validated questionnaires, relying instead on clinical assessments and patient reporting. The sample size for the late training group was small (25 patients) compared to the early training group (75 patients). The study did not collect specific data on cognitive or physical decline in the multiple sclerosis group, so the reason for their poorer technique and higher infection rates remains a hypothesis rather than a proven cause.
Declared interests
The authors declare no conflicts of interest. The study was conducted at the Bari Polyclinic Unipolar Spinal Unit.
The easy way to misread this
Do not conclude that training timing is irrelevant for all outcomes. While it did not affect adherence, the study did not prove that early training is ineffective for other metrics like patient confidence or immediate skill acquisition, and the small size of the late-training group limits the certainty of the null finding for timing.