The burden of illness in initiating intermittent catheterization: an analysis of German health care claims data

Abstract

Background Intermittent catheterization (IC) is a common medical technique to drain urine from the bladder when this is no longer possible by natural means. The objective of this study was to evaluate the standard of care and the burden of illness in German individuals who perform intermittent catheterization and obtain recommendations for improvement of care. Methods A descriptive study with a retrospective, longitudinal cohort design was conducted using the InGef research database from the German statutory health insurance claims data system. The study consisted of individuals with initial IC use in 2013–2015. Results Within 3 years 1100 individuals with initial IC were identified in the database (~ 19,000 in the German population). The most common IC indications were urologic diseases, spinal cord injury, Multiple Sclerosis and Spina Bifida. Urinary tract infections (UTI) were the most frequent complication occurring 1 year before index (61%) and in follow-up (year 1 60%; year 2 50%). Resource use in pre-index including hospitalizations (65%), length of stay (12.8 ± 20.0 days), physician visits (general practitioner: 15.2 ± 29.1), prescriptions of antibiotics (71%) and healthcare costs (€17,950) were high. Comorbidities, complications, and healthcare resource use were highest 1 year before index, decreasing from first to second year after index. Conclusions The data demonstrated that prior to initial catheterization, IC users experienced UTIs and high healthcare utilization. While this demonstrates a potential high burden of illness prior to initial IC, UTIs also decreased over time, suggesting that IC use may have a positive influence. The findings also showed that after the first year of initial catheterization the cost decreased. Further studies are needed to better understand the extent of the burden for IC users compared to non-IC users.

Comparing an Integrated Amphiphilic Surfactant to Traditional Hydrophilic Coatings for the Reduction of Catheter-Associated Urethral Microtrauma

“…Postcatheterization, PVP-coating was observed to remain behind on the urethral model, suggesting that hydrophilic PVP-coated catheters have the potential to leave coating residue behind in the urethra on withdrawal from a patient’s bladder. Importantly, the urethral model was catheterized once, however, in vivo intermittent catheterization is performed multiple times a day. , This raises the question of whether delamination of hydrophilic PVP-coated catheters occurs in vivo and what clinical consequences accumulation of these residues might have. The clinical relevance and long-term significance of hydrophilic PVP-coated catheters’ adhesive characteristics, coating delamination and coating residues remain unknown .…”

“…Importantly, the urethral model was catheterized once, however, in vivo intermittent catheterization is performed multiple times a day. 29 , 30 This raises the question of whether delamination of hydrophilic PVP-coated catheters occurs in vivo and what clinical consequences accumulation of these residues might have. The clinical relevance and long-term significance of hydrophilic PVP-coated catheters’ adhesive characteristics, coating delamination and coating residues remain unknown.…”

The cost of lifelong LUTS—A systematic literature review

“…The costs of LUTS were explored in several countries. The United States had the highest number of studies (n = 15, 33.3%), [7][8][9][10][11][12][13][14][15][16][17][18][19][20] however, Germany (n = 3, 6.7%), [21][22][23] Italy (n = 3, 6.7%), [24][25][26] and South Korea (n = 3, 6.7%) [27][28][29] contributed proportionally high. Several counties only had one-two studies, including Australia, Denmark, Brazil, Canada, China, France, Spain, the United Kingdom, Hungary, Ireland, Poland, Sweden, Switzerland, and Taiwan.…”

New micro-hole zone catheter reduces residual urine and mucosal microtrauma in a lower urinary tract model

“…UTI incidence in patients practicing CIC varies widely, depending on LUTD causes, time of assessment after initiation of catheterization, patient-related parameters, as well as how such infections are defined in each study. Values ranging from as low as 2% 2 , to as high as over 70% 5 have been reported, and incidence over 30% is not uncommon 6 – 9 .…”