Comparing Patient and Clinician Perceptions of Health-Related Quality of Life in Urinary Tract Infections.

IMPORTANCE: There is limited research comparing patient- and clinician-reported health-related quality of life (HRQOL) in patients with infections. OBJECTIVE: To compare what patients with complicated urinary tract infections (UTIs) describe about their HRQOL with the perceptions of their treating clinicians. DESIGN, SETTING, AND PARTICIPANTS: This qualitative study used semistructured interviews of hospitalized patients with complicated UTI and clinicians who cared for them for at least 2 days at 2 academic hospitals in the southeastern US. The interviews were conducted between February 7 and May 26, 2023, with the analysis completed between May 1, 2023, and September 3, 2024. MAIN OUTCOMES AND MEASURES: The main outcome was how clinician perceptions and patient experiences and descriptions aligned and diverged for different aspects of patient HRQOL. Directed content matrix and team-based qualitative techniques were used to facilitate analysis and presentation. RESULTS: Interviews were conducted with 12 patients (median [IQR] age, 70 [60-78] years; 7 male [58.3%]) and 16 clinicians (median [IQR] age, 35 [31-43] years; 9 female [56.3%]). Four key concepts were identified: (1) the full range of impact of complicated UTI symptoms on patient functioning was not consistently recognized by clinicians, (2) clinicians' perceptions of HRQOL were influenced by patients' medical conditions and concerns about misattribution of symptoms to a UTI, (3) different terms and level of detail were used by patients and clinicians to describe HRQOL associated with complicated UTI, and (4) clinicians believe that HRQOL is important but approach their role in addressing HRQOL with varied experience and comfort. CONCLUSIONS AND RELEVANCE: This qualitative study of patients and their treating clinicians found important differences in how patients and clinicians perceive and describe the impact of complicated UTI on patient HRQOL. Understanding how patient and clinician perceptions of HRQOL diverge may help with the design of patient-centered outcomes for clinical trials and identify areas for enhanced patient-clinician communication.

Duke Scholars

Author Felicia Ruffin  

Author Bryce B. Reeve Population Health Sciences

Author Heather Alyse King Population Health Sciences

Author Vance Garrison Fowler Jr. Medicine, Infectious Diseases

Author Hayden Barry Bosworth Population Health Sciences