Outcome of UTI similar after telephone management, office care

המידע באדיבות medicontext.co.il
Last Updated: 2001-08-06 16:03:06 EDT (Reuters Health)

WESTPORT, CT (Reuters Health) – Short-term outcomes of urinary tract infections (UTIs) in women are similar whether the patient receives advice over the telephone or an office examination, according to the results of a study conducted at six primary care offices in Michigan.

That study, by Dr. Henry C. Barry and colleagues, from Michigan State University in East Lansing, involved women who called their physician with a suspected UTI. After being questioned by a nurse, those who were otherwise healthy were randomized to telephone care (36 patients) or office care (36 patients). About half of the callers were ineligible to participate.

Those in the telephone group were asked to go to their clinic to leave a urine sample and get a prescription for antibiotics. All patients in both groups were treated with antibiotics for 7 days. At baseline the two groups were similar in terms of symptom scores and an overall UTI score on a scale developed by the researchers.

Overall, 43 urine cultures (64.2%) were positive, the team reports in the July issue of The Journal of Family Practice. Of these, 34 (79.1%) grew Escherichia coli. Twenty-three of 34 cultures (67.6%) were positive in the usual-care group, compared with 20 of 33 cultures (60.6%) in the telephone group (p = 0.55).

The investigators found no significant differences between the groups with regard to changes in symptom scores or UTI score from baseline to day 3 or 10. "By day 10, six of 35 control patients (17.1%) had persistent symptoms, compared with 12 of 35 (34.3%) in the telephone group" (p = 0.1). The research team acknowledges that the lack of statistical significance of this finding might be attributable to the small number of patients studied.

At the end of the study there was no significant difference between groups in satisfaction with care, and satisfaction was high overall.

"In managed care settings, the financial incentives to reduce utilization make this practice inexpensive while simultaneously maintaining high patient satisfaction," Dr. Barry and colleagues conclude.

J Fam Pract 2001;50:589-594.

-Westport Newsroom 203 319 2700

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