Everly Health, Inc., Austin, Texas, United States of America.
University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America.
PLoS One. 2023 Feb 2;18(2):e0280386. doi: 10.1371/journal.pone.0280386. eCollection 2023.
Telemedicine programs for the treatment of urinary tract infections (UTIs) offer an opportunity to reduce burdens on patients and providers. However, these programs are typically restricted to patients with uncomplicated UTIs. This real-world analysis evaluated treatment and resolution rates in a large-scale, national UTI telemedicine program inclusive of patients with uncomplicated and complicated UTIs. We conducted a retrospective analysis of data obtained from a commercially available telemedicine program for the treatment of UTIs among adult women in the US between 2017 and 2021 (n = 51,474). The primary outcomes were the number of women who presented with symptoms of uncomplicated UTI, complicated UTI, and vaginal infection; prescription use and antibiotic type; symptom resolution within seven days after appointment; and treatment failure or relapse. Most patients reported frequent urination (94.4%), urgency (94.5%), and dysuria (97.6%). Those with uncomplicated UTI symptoms represented the majority of patients (61.6%); however, a substantial number of patients (36.5%) also reported at least one symptom associated with a complicated UTI. One-fifth of patients (19.2%) reported at least one co-occurring symptom of vaginal infection or sexually transmitted infection. Across all treated patients, 94.0% received recommended antibiotics according to the clinical protocol. Of the treated patients who provided follow-up data (n = 3,521), 89.7% reported seven-day symptom resolution. Symptom resolution rates were similar between patients with uncomplicated UTI symptoms (90.8%) and complicated UTI symptoms (87.9%), and symptom resolution among all treated patients (89.7%) was similar to reports for in-person standard of care. These findings suggest that large-scale telemedicine programs for the treatment of UTIs can be effective in the treatment of complicated UTIs.
远程医疗计划为治疗尿路感染（UTI）提供了机会，可以减轻患者和医务人员的负担。然而，这些计划通常仅限于患有单纯性 UTI 的患者。本真实世界分析评估了一个大型全国性 UTI 远程医疗计划中包括单纯性和复杂性 UTI 患者的治疗和缓解率。我们对 2017 年至 2021 年期间美国成年女性接受商业性远程医疗计划治疗 UTI 的患者数据进行了回顾性分析（n = 51474）。主要结局是出现单纯性 UTI、复杂性 UTI 和阴道感染症状的女性人数、处方使用和抗生素类型、预约后七天内症状缓解情况，以及治疗失败或复发情况。大多数患者报告有尿频（94.4%）、尿急（94.5%）和尿痛（97.6%）。大多数患者（61.6%）报告有单纯性 UTI 症状，但相当数量的患者（36.5%）也报告了至少一种与复杂性 UTI 相关的症状。五分之一的患者（19.2%）报告至少有一种同时存在的阴道感染或性传播感染的症状。在所有接受治疗的患者中，根据临床方案，94.0%的患者接受了推荐的抗生素。在提供了随访数据的治疗患者中（n = 3521），89.7%的患者报告了七天症状缓解。单纯性 UTI 症状患者（90.8%）和复杂性 UTI 症状患者（87.9%）的症状缓解率相似，所有接受治疗的患者（89.7%）的症状缓解率与面对面标准护理的报告相似。这些发现表明，大规模远程医疗计划治疗 UTI 可有效治疗复杂性 UTI。
