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Research project: Improving care in the management of older people with long-term urinary catheters - Dormant - Dormant

Currently Active: 
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Problems with urinary control affect up to 20% of the general population rising to 25% or more in those over 75 years or with physical disabilities, including many younger people with neurological injury/disease. Urinary incontinence (UI) is a distressing experience which can have a devastating effect on patients, families and carers, and can be a major contributor to the movement of patients from a home setting to institutionalised care.

Overview

Although often seen as a last resort, urinary catheterisation (a tube inserted into the bladder to drain into a bag) is a common management option for urinary control. But long-term catheters (LTC) can be difficult to manage by people with complex disabilities and are frequently problematic, with many complications including infection, blockage and leakage. Although manufacturers have modified catheter materials in an attempt to overcome some of these problems the basic catheter system has hardly changed at all in the last 50 years. More technical innovations directed at effective bladder drainage, via a catheter or by other means, are urgently needed to provide less problematic and more acceptable solutions to users. For this to happen we need firm data to work on. We need to find out who uses catheters and characterise their needs and abilities; we need to account for and describe the costs involved with the present system and we need to find out how catheter systems affect quality of life, through listening to users and carers. We will then have the tools to develop new systems, designed to meet the needs of users and be able to measure the effects of new innovations on costs and quality of life.

Main question(s)

The aims of this study are to describe the characteristics of catheter users; develop and test instruments designed to identify and prioritise catheter users'/carers' needs and abilities, and to measure quality of life; determine catheter management costs; establish a longitudinal data base.

Methodology

The study will comprise three overlapping phases: (1) preliminary phase determining routes to identify and access individuals with LTCs; patient interviews and identification of items for instrument development and costs analysis; (2) an iterative process of instrument testing and refinement with larger sample; (3) extended testing with a large LTC user population. Data on t he extent and pattern of expenditure on catheter management in each major group of users will be collected through interviews with patients (and their carers) and from examination of patient notes held by district nursing services and GPs.

Main outcomes

  1. Development of robust instruments for patient assessment and cost analysis which can be used to inform clinical guidance and new product design & evaluation.
  2. Analysis of the impact and resource implications of LTC use in community settings.
  3. Setting up a longitudinal database of LTC users.

Project team

Mandy Fader, Kathryn Getliffe

Project funder

Acton Medical Research

Related research groups

Active Living and Rehabilitation
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