Participants’ experiences of ketamine bladder syndrome: A qualitative study

Abstract

The aim of this study is to explore recreational ketamine users’ experiences of ketamine bladder syndrome (KBS) and related health care provision issues. KBS is an emerging condition caused by chronic, recreational ketamine use, which can result in extensive, irreparable damage to the bladder and urinary tract. However, little is yet known about how patients are personally affected by the condition, their help seeking behaviour or experiences of related health care services. A qualitative study, informed by Heideggerian hermeneutics was undertaken. Twelve participants affected by KBS were purposively recruited into the study from an National Health Service (NHS) continence service and a drug support agency in South Wales, UK. Data were collected through recorded, semi‐structured interviews and analysed using a three‐step approach. Participants were predominantly younger, poly‐drug users and typically developed KBS following prolonged, habitual ketamine use. The effects of KBS were considerable and included incontinence, haematuria, profound abdominal pain and embarrassment and were exacerbated by delays in help seeking, disjointed medical care and on‐going ketamine use, which was integral to the self‐management of KBS pain. KBS has significant impact on those affected and can result in extensive, irreversible damage to the bladder and urinary tract. The condition, and its management, is further compounded by chronic poly‐drug use, chaotic lifestyles and a range of complex, related co‐morbidities, which require a collaborative, multi‐disciplinary approach. Anderson's behavioural model of health services use provides an appropriate framework for better understanding help seeking/avoidance behaviour in this cohort, which can help inform clinical practice.

Application of Andersen’s behavioural model of health services use: a scoping review with a focus on qualitative health services research

“… 22 25 35 48 89 91–93 Some studies 22 25 described that cultural factors are not adequately represented in the model: ‘the model has been noted not to be sensitive to the diverse cultural and structural barriers in healthcare among minority groups’. 25 According to the authors of some publications, 35 48 the model would need to further elaborate on the relationship between the three core factors of the BMHSU and the relevance of each. Other authors claimed that the model does not cover all factors of healthcare utilisation, such as psychosocial factors, 22 and would be less suitable for studies on HIV 89 or healthcare coverage.…”