Impact of sociodemographic status and UTI symptoms on women's health-seeking and management in England: findings from an e-survey conducted during the first year of the COVID-19 pandemic

Cooper, Emily, Read, Brieze, Sanyaolu, Leigh ORCID: https://orcid.org/0000-0002-6762-6986, Ahmed, Haroon ORCID: https://orcid.org/0000-0002-0634-8548 and Lecky, Donna 2023. Impact of sociodemographic status and UTI symptoms on women's health-seeking and management in England: findings from an e-survey conducted during the first year of the COVID-19 pandemic. British Journal of General Practice Open 2023 , 0039. 10.3399/BJGPO.2023.0039

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Abstract

Background Multiple factors may influence women’s experiences of urinary tract infection (UTI) and its clinical management. Aim To explore how women’s background, symptoms, and severity of symptoms influence UTI reporting and management. Design & setting Internet questionnaire targeting women in England, focusing on UTI symptoms, care seeking, and management. Method A total of 1096 women aged ≥16 years with UTI symptoms in the previous year completed the questionnaire in March and April 2021. Multivariable logistic regression was ued to estimate the odds of relevant outcomes while adjusting for background characteristics. Results Women with children in their household, who were aged under 45 years, or who were married or cohabitating were more likely to experience UTI symptoms. The odds of antibiotic prescribing were lower if women reported dysuria (adjusted odds ratio [AOR] = 0.65, 95% confidence interval [CI] = 0.49 to 0.85), frequency (AOR = 0.63, 95% CI = 0.48 to 0.83), or vaginal discharge (AOR = 0.69, 95% CI = 0.50 to 0.96), but higher if reporting haematuria (AOR = 2.81, 95% CI = 1.79 to 4.41), confusion (AOR = 2.14, 95% CI = 1.16 to 3.94), abdominal pain (AOR = 1.35, 95% CI = 1.04 to 1.74), or systemic symptoms (AOR = 2.04, 95% CI = 1.56 to 2.69). Those with abdominal pain or two or more of nocturia, dysuria, or cloudy urine had lower odds of receiving a delayed antibiotic, while those with incontinence, confusion, unsteadiness, or low temperature had higher odds of a delayed prescription. Increasing symptom severity was associated with greater odds of receiving antibiotics. Conclusion Except for reduced prescribing if a woman had dysuria and frequency, antibiotic prescribing followed an expected pattern, aligning generally with national guidance. Symptom severity and the likelihood of systemic infection probably influenced care seeking and prescribing. Sexual intercourse and childbirth may be key times to target women with messages about UTI prevention.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Royal College of General Practitioners
ISSN:	2398-3795
Date of First Compliant Deposit:	17 October 2023
Date of Acceptance:	30 June 2023
Last Modified:	20 Oct 2023 13:45
URI:	https://orca.cardiff.ac.uk/id/eprint/163236

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