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Recurrent Lower Urinary Tract Infections Have a Detrimental Effect on Patient Quality of Life: a Prospective, Observational Study.

Renard J, Ballarini S, Mascarenhas T, Zahran M, Quimper E, Choucair J, Iselin CE - Infect Dis Ther (2014)

Bottom Line: For each parameter, the comparison between Day 0 and Day 180 was performed using Wilcoxon signed-rank test for quantitative data.At the end of the study (Day 180), the mean number of UTI decreased by 59.3% (P ≤ 0.0001), the total HAD score decreased by 32.1% (P ≤ 0.0001), and the mean Leicester score decreased by 44.0% (P ≤ 0.0001) from baseline.This study showed that rUTI had a negative impact on patients' QoL and that effective alternative prophylaxis significantly improved their QoL.

View Article: PubMed Central - PubMed

Affiliation: University Hospital of Geneva, Geneva, Switzerland.

ABSTRACT

Introduction: This study investigated the effects of recurrent urinary tract infections (rUTI) and the impact of prophylaxis on rUTI and patients' quality of life (QoL).

Methods: Altogether, 575 patients affected by rUTI were included in a 6-month observational study. QoL was assessed using the Hospital Anxiety and Depression (HAD) and the Leicester scales. Statistical analyses were performed using SAS(®) Version 8.2 software (SAS Institute Inc., Cary, NC, USA). The significance level was set at 5%. Spearman correlation was used to assess the degree of correlation between infectious episodes and HAD and Leicester scores. For each parameter, the comparison between Day 0 and Day 180 was performed using Wilcoxon signed-rank test for quantitative data.

Results: In total, 61.9% of patients suffering from rUTI exhibited some degree of depression at baseline (Day 0). Alternative oral non-antimicrobial prophylactic treatment for rUTI [Escherichia coli lyophilized bacterial lysate (OM-89)] was administered to 94.4% of patients (1 capsule a day for 90 days), followed by a 3-month treatment-free period. At the end of the study (Day 180), the mean number of UTI decreased by 59.3% (P ≤ 0.0001), the total HAD score decreased by 32.1% (P ≤ 0.0001), and the mean Leicester score decreased by 44.0% (P ≤ 0.0001) from baseline. There was a correlation trend between the reduction in the numbers of UTI at the end of the study compared to the 6 months prior to study entry and the reduction in the anxiety, depression, total HAD scores, activity, feeling, and total Leicester scores registered from Day 0 to Day 180, suggesting a lessening of emotional problems, and social and functional handicaps with decreasing UTI incidence.

Conclusions: This study showed that rUTI had a negative impact on patients' QoL and that effective alternative prophylaxis significantly improved their QoL.

No MeSH data available.


Related in: MedlinePlus

Reduction of Leicester scores and number of UTIs between Day 0 and Day 180—Analysis population (N = 575). The Leicester impact scale was divided into four categories: 0–14, 15–20, 21–30, and 31–42. A score of >14 indicated that the patient had some degree of functional or social handicap, a score of >20 was suggestive of a major social or functional handicap, and a score >31 indicated major social and functional handicaps. Asterisk the percentage reduction from Day 0. All statistically significant (P ≤ 0.0001). UTI urinary tract infection
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Fig4: Reduction of Leicester scores and number of UTIs between Day 0 and Day 180—Analysis population (N = 575). The Leicester impact scale was divided into four categories: 0–14, 15–20, 21–30, and 31–42. A score of >14 indicated that the patient had some degree of functional or social handicap, a score of >20 was suggestive of a major social or functional handicap, and a score >31 indicated major social and functional handicaps. Asterisk the percentage reduction from Day 0. All statistically significant (P ≤ 0.0001). UTI urinary tract infection

Mentions: The mean activity score was 10.4 (SD = 4.7) on Day 0, and 4.0 (SD = 5.6) on Day 180, showing a statistically significant 32.7% decrease from baseline (P ≤ 0.0001). The mean feeling score was 9.1 (SD = 5.0) on Day 0, and 4.1 (SD = 4.2) on Day 180, which corresponds to a statistically significant decrease of 54.9% from baseline (P ≤ 0.0001). The mean Leicester score decreased from 19.3 (SD = 8.1) on Day 0 to 10.8 (SD = 7.9) on Day 180, representing a statistically significant decrease of 44.0% compared with baseline (P ≤ 0.0001). The mean number of urinary episodes was 2.7 (SD = 1.2) on Day 0, and 1.1 (SD = 1.1) on Day 180, showing a statistically significant decrease of 59.3% from baseline (P ≤ 0.0001). There was a correlation trend between the reduction in number of UTIs from Day 0 to Day 180 and the reduction in the activity, feeling, and total Leicester scores. These statistically significant reductions suggest a lessening of social and functional handicap with decreasing UTI incidence (Fig. 4).Fig. 4


Recurrent Lower Urinary Tract Infections Have a Detrimental Effect on Patient Quality of Life: a Prospective, Observational Study.

Renard J, Ballarini S, Mascarenhas T, Zahran M, Quimper E, Choucair J, Iselin CE - Infect Dis Ther (2014)

Reduction of Leicester scores and number of UTIs between Day 0 and Day 180—Analysis population (N = 575). The Leicester impact scale was divided into four categories: 0–14, 15–20, 21–30, and 31–42. A score of >14 indicated that the patient had some degree of functional or social handicap, a score of >20 was suggestive of a major social or functional handicap, and a score >31 indicated major social and functional handicaps. Asterisk the percentage reduction from Day 0. All statistically significant (P ≤ 0.0001). UTI urinary tract infection
© Copyright Policy
Related In: Results  -  Collection

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Fig4: Reduction of Leicester scores and number of UTIs between Day 0 and Day 180—Analysis population (N = 575). The Leicester impact scale was divided into four categories: 0–14, 15–20, 21–30, and 31–42. A score of >14 indicated that the patient had some degree of functional or social handicap, a score of >20 was suggestive of a major social or functional handicap, and a score >31 indicated major social and functional handicaps. Asterisk the percentage reduction from Day 0. All statistically significant (P ≤ 0.0001). UTI urinary tract infection
Mentions: The mean activity score was 10.4 (SD = 4.7) on Day 0, and 4.0 (SD = 5.6) on Day 180, showing a statistically significant 32.7% decrease from baseline (P ≤ 0.0001). The mean feeling score was 9.1 (SD = 5.0) on Day 0, and 4.1 (SD = 4.2) on Day 180, which corresponds to a statistically significant decrease of 54.9% from baseline (P ≤ 0.0001). The mean Leicester score decreased from 19.3 (SD = 8.1) on Day 0 to 10.8 (SD = 7.9) on Day 180, representing a statistically significant decrease of 44.0% compared with baseline (P ≤ 0.0001). The mean number of urinary episodes was 2.7 (SD = 1.2) on Day 0, and 1.1 (SD = 1.1) on Day 180, showing a statistically significant decrease of 59.3% from baseline (P ≤ 0.0001). There was a correlation trend between the reduction in number of UTIs from Day 0 to Day 180 and the reduction in the activity, feeling, and total Leicester scores. These statistically significant reductions suggest a lessening of social and functional handicap with decreasing UTI incidence (Fig. 4).Fig. 4

Bottom Line: For each parameter, the comparison between Day 0 and Day 180 was performed using Wilcoxon signed-rank test for quantitative data.At the end of the study (Day 180), the mean number of UTI decreased by 59.3% (P ≤ 0.0001), the total HAD score decreased by 32.1% (P ≤ 0.0001), and the mean Leicester score decreased by 44.0% (P ≤ 0.0001) from baseline.This study showed that rUTI had a negative impact on patients' QoL and that effective alternative prophylaxis significantly improved their QoL.

View Article: PubMed Central - PubMed

Affiliation: University Hospital of Geneva, Geneva, Switzerland.

ABSTRACT

Introduction: This study investigated the effects of recurrent urinary tract infections (rUTI) and the impact of prophylaxis on rUTI and patients' quality of life (QoL).

Methods: Altogether, 575 patients affected by rUTI were included in a 6-month observational study. QoL was assessed using the Hospital Anxiety and Depression (HAD) and the Leicester scales. Statistical analyses were performed using SAS(®) Version 8.2 software (SAS Institute Inc., Cary, NC, USA). The significance level was set at 5%. Spearman correlation was used to assess the degree of correlation between infectious episodes and HAD and Leicester scores. For each parameter, the comparison between Day 0 and Day 180 was performed using Wilcoxon signed-rank test for quantitative data.

Results: In total, 61.9% of patients suffering from rUTI exhibited some degree of depression at baseline (Day 0). Alternative oral non-antimicrobial prophylactic treatment for rUTI [Escherichia coli lyophilized bacterial lysate (OM-89)] was administered to 94.4% of patients (1 capsule a day for 90 days), followed by a 3-month treatment-free period. At the end of the study (Day 180), the mean number of UTI decreased by 59.3% (P ≤ 0.0001), the total HAD score decreased by 32.1% (P ≤ 0.0001), and the mean Leicester score decreased by 44.0% (P ≤ 0.0001) from baseline. There was a correlation trend between the reduction in the numbers of UTI at the end of the study compared to the 6 months prior to study entry and the reduction in the anxiety, depression, total HAD scores, activity, feeling, and total Leicester scores registered from Day 0 to Day 180, suggesting a lessening of emotional problems, and social and functional handicaps with decreasing UTI incidence.

Conclusions: This study showed that rUTI had a negative impact on patients' QoL and that effective alternative prophylaxis significantly improved their QoL.

No MeSH data available.


Related in: MedlinePlus