Self-management intervention for long-term indwelling urinary catheter users: randomized clinical trial

Abstract

Background: People using long-term indwelling urinary catheters experience multiple recurrent catheter problems. Self-management approaches are needed to avoid catheter-related problems.

Objectives: The aim was to determine effectiveness of a self-management intervention in prevention of adverse outcomes (catheter-related urinary tract infection, blockage, and accidental dislodgement). Healthcare treatment associated with the adverse outcomes and catheter-related quality of life was also studied.

Methods: A randomized clinical trial was conducted. The intervention involved learning catheter-related self-monitoring and self-management skills during home visits by a study nurse (twice during the first month and at 4 months-with a phone call at 2 months). The control group received usual care. Data were collected during an initial face-to-face home interview followed by bimonthly phone interviews. A total of 202 adult long-term urinary catheter users participated. Participants were randomized to treatment or control groups following collection of baseline data. Generalized estimating equations were used for the analysis of treatment effect.

Results: In the intervention group, there was a significant decrease in reported blockage in the first 6 months (p = .02), but the effect did not persist. There were no significant effects for catheter-related urinary tract infection or dislodgment. Comparison of baseline rates of adverse outcomes with subsequent periods suggested that both groups improved over 12 months.

Discussion: A simple-to-use catheter problems calendar and the bimonthly interviews might have functioned as a modest self-monitoring intervention for persons in both groups. A simplified intervention using a self-monitoring calendar is suggested-with optimal and consistent fluid intake likely to add value.

Trial registration: ClinicalTrials.gov NCT00883220.

Conflict of interest statement

Conflicts of Interest Statements: Mary H. Wilde has been a consultant with NovaBay Pharmaceutics Inc. since June 2013. The remaining authors have no conflicts of interest to report.

Figures

FIGURE 1

Theoretical model for self-management of urine flow intervention (Wilde, Zhang et al., 2013). Used with permission.

FIGURE 2

CONSORT flow diagram