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Practice nurse led treatment more effective for male UTIs

Practice nurse led treatment more effective for male UTIs

A new treatment intervention that practice nurses and health care assistants can deliver has been shown to be very effective at reducing male urinary tract infections (UTIs).

Researchers from the University of Bristol found that men with persistent UTIs were more effectively treated through a practice nurse consultation and the provision of an information booklet rather than standard treatment such as bladder training and controlling fluid intake.

The findings from the study, which involved over 1,000 participants and 30 GP practices, are published in the BMJ.

As men age, the severity and prevalence of lower urinary tract symptoms (LUTS) increases, with men over 65 nearly a third more likely to suffer symptoms than younger men. UTIs can seriously affect the quality of life, but in many cases, they can be influenced by lifestyle factors.

Currently, UTIs are treated according to the National Institute for Health and Care Excellence (NICE) guidelines, which involve bladder training, controlling fluid intake and offering lifestyle advice. However, evidence of the effectiveness of this type of treatment needs to be improved, and GP provision is often inconsistent across practices.

To test the effectiveness of the new intervention, the researchers recruited 1,077 adult men, each suffering from persistent urinary tract symptoms between June 2018 and August 2019, as part of the University of Bristol-led Treating Urinary Symptoms in Men in Primary Healthcare (TRIUMPH) study.

The men were divided into two groups, one that received standard treatment and a second that received the new treatment interventions. Participants in the new intervention group met with a practice nurse, healthcare assistant or research nurse within the GP practice and were directed to relevant sections of the information booklet. The patient was then contacted over the next 12 weeks to see how they were getting on.

The study found that men with moderate symptom severity who had been treated by practice nurses and healthcare assistants in the new manualised approach did better overall in a 12-month period than those treated using standard methods.

The new intervention led to a more significant reduction in symptoms, with the difference being maintained over a longer period of time.

Consultant Urologist Professor Marcus Drake, the study’s chief investigator, said: ‘Implementation of this intervention as management in primary care has the potential to improve care and reduce drug prescriptions. Our study also found the intervention can be delivered by practice nurses or healthcare assistants rather than GPs.’

The researchers hope the findings will become a vital part of the toolkit for any clinician managing male patients with persistent UTIs.

Dr Jon Rees, GP partner at Tyntesfield Medical Group and chair of the Primary Care Urology Society, added: ‘In primary care, we have often traditionally relied upon pharmaceutical management for men with bothersome urinary symptoms – the TRIUMPH study emphasises the importance of discussing conservative measures with all of these patients – for some men, this will be all that is required, for others these measures can act as an adjunct to any medication prescribed.’


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