ImpresU- Improving rational prescribing for UTI in frail elderly

Frail elderly, particularly those receiving home care or living in a care home, constitute a vulnerable and under researched population. They are frequently diagnosed with urinary tract infection (UTI) and almost 60% of the antibiotics (AB) used in this population are for UTI. Diagnosing UTI is challenging in frail elderly, due to atypical illness presentation, the lack of reliable diagnostics and the high prevalence of (asymptomatic) bacteriuria.These factors increase the risk of AB overuse.

Previous studies have shown that antimicrobial resistance is a growing problem in long term care. Therefore, antibiotic stewardship interventions (ASI) are much needed in the continuum of home care and institutional care settings for frail elderly. For this purpose, the studies proposed here aim to reduce AB overuse for UTI in this population through implementation of a new algorithm - developed by an international Delphi panel - to support clinical decision making on signs and symptoms that justify a ‘watchful waiting’ approach in cases of suspected UTI in frail elderly.

Core of this intervention will be the implementation of the decision support algorithm. This will be combined with complementary interventions, selected together with the study participants (care staff, nurses, physicians) using the conceptual model and applying this to their specific setting and care practice.

In addition, we will conduct a double blinded RCT on the safety and effectivity of prophylactic treatment with methenamine hippurate in older women with recurrent UTI. The results of this trial will help to further strengthen ASI in this group of patients.

Prosjektbeskrivelse med vedlegg

TSD

  • Ja

Biobank

  • Nei

Godkjenninger

Intern fremleggelse - Ja

Godkjent av: Jørund Straand

NSD - Ikke behov

Prosjektet er godkjent i REK og SLV og det utarbeides separate avtaler med UiO som sponsor og de utenlandske aktørene om datahåndtering

REK - Ja 6 filer

Statens legemiddelverk - Ja 2 filer

Andre godkjenninger6 filer

Prosjektleder

Morten Lindbæk

Ansvarlig enhet

Avdeling for allmennmedisin

Forskere

  • Silje Rebekka Heltveit-Olsen
  • Cees Hertogh (Universitetet i Amsterdam)
  • Theo Verheij (Universitetet i Utrecht)
  • Per Daniel Sundvall (Universitetet i Gøteborg)
  • Maciek Godycki-Cwirko (Universitetet i Lodz)

Prosjekttype

  • Ph.d.-prosjekt

Helsefaglig forskning

  • Ja

Personopplysninger

  • Ikke besvart

Tidsperiode

  • Start: januar 2019
  • Slutt: desember 2025
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