Disease burden of recurrent urinary tract infections on healthcare systems and patients
Burden on patients
1 in 2 women of all ages will experience at least one episode of cystitis during their lifetime
Of these women, almost 1 in 3 will suffer from at least one recurrent UTI
In a patient web-based study (GESPRIT) performed in 5 countries by individuals affected by rUTIs:
- Anonymous, self-administered web-based survey
- Aim: to evaluate the social & economic burden of rUTIs as well as impact on QoL
- 5 countries involved (Germany, Switzerland, Poland, Russia, Italy)
- 1,941 adult women who had experienced rUTIs and were currently affected by acute UTI (1,275) or within 4 weeks of study entry (666)
The following topics were covered in the GESPRIT questionnaire:
- Demographics
- Disease and disease burden (self-reported disease history)
- Knowledge – Use - Willingness (antibiotic use and prevention)
- Socio-economic aspects
- Quality of Life (SF-12v2) Burden of illness
- Other personal information (marital status, employment, income)
Impact on daily activities
Women…
…stated their intimate relations were negatively influenced by the disease
Women…
…suffered UTIs very often or often after sexual intercourse
Women…
…felt limited in their daily activities by more than 3 days per year
Premenopausal women…
…reported being socially handicapped
Burden on healthcare and society
Impact on mental well-being
The sudden, unforeseeable, and distressing nature of painful UTI episodes often causes patients anxiety.
- The resulting social handicap is known to induce feelings of self-devaluation or culpability, which can lead to clinical symptoms of depression
- Mental health scores are below average in up to 81% of women, in patients with an acute episode or who recently
experienced a recurrence.
- Up to 71% of women suffering from rUTIs exhibited some degree of depression at baseline
Main symptoms reported by women are:
- 93.7% Pain and/or burning during micturition
- 82.4% Pollakiuria
- 80.1% Dysuria
- 29.8% Asthenia
Women with UTIs were willing to try any sort of prophylactic measure to limit antibiotic consumption.
Find out more about the burden of rUTIs.
Burden of UTIs
- In the US, UTIs are responsible for 7 million medical visits a year, including 2 million for cystitis alone, with a total estimated cost of $3.5 billion.
- In Europe, patients with UTIs visit the doctor 3 times/year, costing an estimated €1.5 billion.
- A mean of 3 days per year of sick leave are due to UTIs in Europe.
Burden of antimicrobials
- 80.3% of UTI patients had been treated at least once with antibiotics for UTIs.
- In the US, 3 million UTI patients are treated with antibiotics.
- Individuals who had to change antibiotic treatment due to lack of efficacy was high (up to 53.2%).
And what about recurrences?
Doctors tend to see cases of cystitis in isolation and don’t see the recurrences, however, for patients even one recurrence is too many. RECAP
Patient's perspective
- 100% of patients surveyed were willing to try any sort of prophylactic measure in place of antibiotics
- For example, 54% were willing to take cranberry juice, and 52% were willing to try immunostimulants
- At time of consultation, 74% of women had even already undertaken some kind of preventative measure
Doctors’ perspective
- Every episode is seen as an acute one without treating recurrence. RECAP
- Cystitis may not be a priority for all doctors. RECAP
- Doctors do not advise starting prophylaxis until patients have experienced a mean 4-5 infections. RECAP
Don’t hesitate to advise your patients to take the online ACSS test
A call for action
- rUTIs have a significant impact on health-related Quality of Life
- They comprise a wide health and economic burden, this is why it is important not to underestimate the broad impact of rUTIs
- Effective approaches to managing recurrent uncomplicated UTIs comprise of:
- Risk factor evaluation (LUTIRE)
- Patient counselling
- Behavioural modification
- Non-antimicrobial prophylaxis RECAP
In the HARMONY study, an effective prophylaxis reducing the number of rUTIs (cystitis) has been associated with increases in patient’s QoL in both mental (anxiety and depression scores) and physical health.
RECAP = Where a claim is followed by the RECAP, this means that this claim is endorsed by the RECAP board of experts.
