Disclosures: Felicia M. Skelton, MD, MS: No financial relationships or conflicts of interest

Objective: To explore current spinal cord injury (SCI) patient attitudes towards contemporary practice patterns for evaluating and treating urinary tract infection (UTI), as well as objectively describe medication adherence to antibiotics prescribed to treat UTI.

Design: Mixed methods (quantitative survey and qualitative interview) Setting : Phone/Online Survey Platforms Participants : Veterans with SCI seen at a Veterans Health Administration (VHA) facility nationwide

Interventions: n/a

Main Outcome Measures: Patient self-reported medication adherence scores using a validated survey tool, The Morisky Medication Adherence Scale-8 (MMAS-8) and themes of patient attitudes and behaviors towards UTIs and antibiotic use following SCI.

Results: 9 qualitative interviews were completed. Themes identified included but are not limited to: generally high adherence to and compliance with prescribed antibiotic courses, level of injury and bladder management strategy as key factors in successful identification and treatment of UTIs, family/caregiver support as important facilitator to successful care and case management and high level of patient satisfaction with current bladder care. A total of 105 MMAS-8 surveys were completed out of 369 distributed surveys, for a response rate of 28%. Overall, patients reported high medication adherence—that is, on average respondents reported a score of 7.2 out of 8—8 being perfect adherence with no intentional nor unintentional non-adherence reported. This converges with themes observed in the qualitative interviews—patients were receptive and compliant to treatment courses prescribed by providers. Participants reported unintentional nonadherence slightly more compared to intentional nonadherence—3.52 compared to 3.68, with 4 being complete adherence. This may suggest a need for patient education regarding different sources of nonadherence. Conclusions: Veterans with SCI are generally happy with their current UTI management and self-report taking medications as prescribed. UTI is common in persons with SCI, and appropriate use of antibiotics helps reduce adverse effects. Information from this study will guide an intervention that promotes appropriate antibiotic use in the SCI population and their healthcare providers.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/mixed-methods-study-to-explore-patient-attitudes-and-behaviors-towards-urinary-tract-infections-and-antibiotic-use-after-spinal-cord-injury/