The goal of this clinical trial is to compare a texting platform to usual care for managing recurrent urinary tract infections (UTI). The main question it aims to answer is: • can a texting platform that integrates symptom triage and prevention education reduce the rate of unnecessary antibiotics for recurrent UTIs as compared to usual care? Participants enrolled onto the texting platform will: • receive evidence-based clinical guidance for the management of symptoms of UTI and receive educational videos on how to prevent UTIs. An important secondary outcome is to determine if the texting platform improves self-efficacy for the management of recurrent UTI.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
104
* An evidence-based algorithm that provides symptom triage and clinical guidance during an episode of acute UTI * Evidence-based prevention education material on recurrent UTIs * 5 standing orders for urinalysis and urine culture in the EHR upon enrollment * Standard-of-care management for recurrent UTI
• Standard-of-care management of recurrent UTI (phone calls and/or secure EHR messages for acute symptoms) and follow up visits as determined by patients and their providers.
University of Pennsylvania
Philadelphia, Pennsylvania, United States
Rate of unnecessary antibiotics
Antibiotics prescribed for patients when 1) urine culture is negative and/or urine microscopy has pyuria \< 10 WBC/HPF, 2) asymptomatic bacteriuria is present, or 3) there is no urine testing and no urinary symptoms.
Time frame: 3 months
Patient self-efficacy
Stanford self-efficacy for managing chronic disease 6-item score (mean score range 1-10 with mean 1 indicating less self-efficacy)
Time frame: 3 months
Patient satisfaction: Patient Global Impression of Improvement score
Patient Global Impression of Improvement score (score range 1-7 with 1 indicating very much better)
Time frame: 3 months
Healthcare-related quality of life: EQ-5D-5L score
EQ-5D-5L score (score range 1-5 for each subscale with 1 indicating no problems)
Time frame: 3 months
Healthcare-related quality of life: Recurrent UTI Impact Questionnaire score
Recurrent UTI Impact Questionnaire score (score range 0-10 for each subscale with 0 indicating strongly disagree)
Time frame: 3 months
Healthcare utilization
Combined number of phone calls, secure messages, telehealth, and/or in-person visits per UTI episode
Time frame: 3 months
Antibiotic prescriptions
Number of antibiotic prescriptions given for UTI episodes
Time frame: 3 months
Patient medication compliance
Medication Adherence Self-Report Inventory score (score range 0-100 with 0 indicating no medication usage)
Time frame: 3 months
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