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Understanding patient perceptions and attitudes toward urinary tract infections and treatment in a medically underserved population
Author(s) -
Minejima Emi,
Lee Eunice,
Quach Stephanie,
Santos Nathan,
Lou Mimi,
WongBeringer Annie
Publication year - 2019
Publication title -
journal of the american college of clinical pharmacy
Language(s) - English
Resource type - Journals
ISSN - 2574-9870
DOI - 10.1002/jac5.1071
Subject(s) - medicine , odds ratio , psychological intervention , logistic regression , urinary system , embarrassment , population , feeling , family medicine , confidence interval , nursing , psychology , environmental health , social psychology
Background Patient understanding and attitude toward urinary tract infections (UTIs) may influence successful infection management and prevention of reinfections. We aimed to identify current gaps in a medically underserved population that may hinder delivery of effective education on UTI management for use in developing future antimicrobial stewardship interventions. Methods Adult, hospitalized patients with community‐onset UTI were recruited. Bedside interviews using a standardized questionnaire were conducted to assess patient perception of their knowledge and attitudes toward UTIs and management. Language used to conduct the interview was recorded. Results Overall, 120 patients were included: 44% English speaking, 74% Hispanic, 66% foreign born, and 38% male. Over half (56%) of the interviews were conducted in a non‐English language, with Spanish being the most predominant (54%). Most patients responded having “very poor” or “poor” self‐reported understanding of what a UTI is (58%), knowing the causes of UTI (70%), and how to treat a UTI (56%). By multivariable logistic regression analysis, English speaking was the most significant factor of responding positively of “very good” or “good” to the self‐reported understanding of UTI (odds ratio [OR] 4.96, 95% confidence interval [CI] 2.22 to 11.6, P < 0.0001), while older age had the reverse outcome (OR 0.97, 95% CI 0.95 to 0.996, P = 0.03). Overall, 97% of patients acknowledged the importance of antibiotics, although only 6% were aware of risks associated with antibiotics. Twenty‐three percent responded feeling embarrassment associated with UTIs. Non‐English‐speaking patients reported less frequent receipt of UTI education from providers (14% vs 47%, P = 0.0001). Approximately one‐third reported trying over‐the‐counter (37%) or home remedies (25%) for their symptoms. Conclusion In a medically underserved population, non‐English‐speaking and older patients had significantly lower self‐reported knowledge of UTIs. Language barrier may have contributed to less provider education and recall of medical advice. Future antimicrobial stewardship interventions should explore alternative communication methods to close the gap in non‐English‐speaking patients.