Uncomplicated UTIs decrease quality of life, productivity, health

Women with uncomplicated urinary tract infections reported negative effects on their sleep, exercise, sexual function, productivity and health-related quality of life, according to findings published in PLOS ONE.

“While the effects of urinary tract infection (UTI) on quality of life have been investigated previously, contemporary studies regarding the key drivers of health-related quality of life, work productivity loss, health care resources use, direct and indirect costs, activity impairment and treatment satisfaction are lacking,” Jeffrey Thompson, PhD, of Cerner Enviza in Malvern, Pennsylvania, and colleagues wrote. “Furthermore, earlier studies on UTI and have not made a clear distinction between complicated UTI and uncomplicated UTI.”

Thompson and colleagues conducted a survey of women who reported having a UTI within 60 days and receiving treatment with an oral antibiotic. Only those who reported no symptoms of complicated UTI within 6 months prior to treatment were included for analyses.

Surveys collected self-reported sociodemographic and health information, comorbidities, information on use of health resources, history of UTI, symptom severity, UTI treatments, activities limited by UTI and direct out-of-pocket costs of infection. Women were matched with participants in the 2020 National Health and Wellness Survey (NHWS).

Activity impairment was measured using the five-item Activity Impairment Assessment, which evaluated how often each daily activity was affected by UTI and ranged from 0 (“none of the time”) to 4 (“all of the time”).

Among 375 women with uncomplicated UTI who completed the questionnaire between July 28 and Sept. 28, 2020, 43.5% had recurrent UTI and 56.8% reported using at least one first-line oral antibiotic.

Activity impairment, quality of life

In total, 66.9% of women reported impaired sexual intercourse, 60.8% reported impaired sleep, 52.3% reported impaired exercise, 51.5% reported impaired ability to do housework/chores and 46.9% reported their social activities were hindered. Recurrence vs. nonrecurrence was associated with greater impairment of shopping/running errands (46% vs. 33%; P = .01), housework/chores (57.7% vs. 46.7%; P = .035) and social activities (54% vs. 41.5%; P = .016).

Women with uncomplicated UTI reported worse health-related quality of life — comprising mental and physical symptoms and health utility — compared with matched NHWS participants. Further, those with recurrent uncomplicated UTI reported worse physical symptoms and health utility compared with those who had nonrecurrent uncomplicated UTI.

Productivity

Compared with NHWS participants, women with uncomplicated UTI reported being more absent from work, being less present at work and worse impairment of work and daily activities (all P < .0001).

Among women with uncomplicated UTI, those with recurrent infections reported worse absenteeism (P = .006), work impairment (P = .021) and daily activity impairment (P = .007) compared with women with nonrecurrent infections.

Health care use, costs

Women with uncomplicated UTI most commonly visited their primary care physician for treatment (68.8%) and spent $1,289 and $515 in direct and indirect costs, respectively. Primary ($491) and urgent ($390) care cost women the most in direct costs. Both direct ($112 vs. $72; P = .032) and indirect ($573 vs. $475; P = .031) costs were greatest for women with recurrent vs. nonrecurrent infection.

“While uncomplicated UTIs are common, their impact on patients should not be underestimated; appropriate treatment is crucial in preventing adverse impacts on quality of life and health care resource use,” Thompson and colleagues wrote.