Mixed-Methods Analysis of Provider-Documented and Patient-Reported Urinary Tract Infection Symptoms Among Veterans With Neurogenic Bladder.
Marissa Wirth, Pooja Solanki, Frances M Weaver and 6 others
PMID 38984527WHAT IT FOUND
Veterans with neurogenic bladder often reported urine color, cloudiness, sediment, or smell as UTI signs.
Participants said fever drove provider diagnosis. Urine changes alone are not enough to diagnose UTI.
Key findings
01Veterans with neurogenic bladder commonly reported non-specific UTI symptoms, especially changes in urine color, sediment, cloudiness, or smell.
02Participants said fever often drove provider UTI diagnosis, even when other symptoms were present.
03Participants described urinary tract-specific discomfort such as bladder being 'squeezed' or 'burning', and these were recorded less often by providers.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only veterans, so findings may not apply to people outside the VA system. Only 23 veterans took part, and low recruitment made some focus groups very small, with 1 to 4 people each. Caregivers were not recruited specifically, although four non-medically trained caregivers contributed during three discussions. The provider-recorded data and the focus-group data were not perfectly matched. Provider data included people with Parkinson's disease and people who did not use catheters, while the focus-group sample did not. The discussions were virtual, so people who could not use Microsoft Teams were not represented. The study describes symptoms and documentation. It does not test whether asking about these symptoms changes UTI diagnosis or antibiotic use.
The easy way to misread this
Do not conclude that urine color or smell alone diagnoses UTI. Guidelines advise against using urine characteristics alone, and only a few participants understood that.