New Guide to Improving UTI Care in the Age of Telehealth

Table of Contents

New Guide to Improving UTI Care in the Age of Telehealth

Summary of Key Takeaways:

New National Guide: A guide was released to improve UTI care, especially for patients seeking help through telehealth.
Focus on Antibiotic Use: The guide helps reduce overuse of antibiotics, a key factor in drug-resistant “superbugs.”
Urine Culture and Testing: Emphasizes the importance of urine cultures, especially for those with frequent UTIs.
Guideline for Complex Cases: Addresses patients with underlying health conditions like organ transplants or chemotherapy.
Virtual Health Care: Recognizes the rise of telehealth and its impact on UTI diagnosis and treatment.

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The New Guide to Improving UTI Care in the Age of Telehealth

Introduction to the Guide

Urinary Tract Infections (UTIs) are one of the most common reasons Americans visit urgent care, with millions seeking treatment each year. Traditionally, these patients would visit their doctor in person, where they would undergo a urine test, followed by appropriate treatment. However, with the rapid rise of telehealth services, many patients can now skip in-person visits and receive prescriptions through online symptom questionnaires or video visits.

While this convenience offers quicker access to care, it also brings new challenges. The potential overuse of antibiotics and the underuse of crucial urine culture tests are among the major concerns that come with remote care. The over-prescription of antibiotics can contribute to the development of antibiotic-resistant bacteria, or “superbugs,” which is why proper testing and diagnosis are more critical than ever.

A new Ann Arbor Guide to Triaging Adults with Suspected UTIs—created by experts from the VA Ann Arbor Healthcare System and the University of Michigan—aims to improve UTI care in telehealth and virtual health settings. This guide helps clinicians decide when to test and when to treat patients, with particular attention to minimizing unnecessary antibiotic prescriptions.

Key Features of the New Guide

Two Algorithms for UTI Treatment
The guide includes step-by-step algorithms designed specifically for non-pregnant women and men. These algorithms provide clear instructions on when to prescribe antibiotics, order tests, or recommend further examination, based on symptoms and patient history.
Importance of Urine Culture
In traditional in-person settings, doctors can collect urine samples for testing. However, in a telehealth scenario, these samples are often missed. The guide encourages providers to request a urine culture whenever possible, especially for patients who frequently experience UTIs. This helps avoid the use of broad-spectrum antibiotics and ensures accurate treatment.
Complex Cases Considered
For patients with underlying health conditions—such as organ transplants, chemotherapy, or kidney disease—the decision to prescribe antibiotics becomes more complex. The guide addresses these situations, ensuring that healthcare providers are equipped to manage more complicated cases appropriately. The guide also highlights when symptoms may indicate a more serious condition, such as a kidney infection or sepsis.
Telehealth’s Impact on Diagnosis
While telehealth has made healthcare more accessible, the guide stresses that virtual consultations alone may not always provide a definitive diagnosis. Although telehealth helps patients avoid travel time, long waiting periods, and other barriers to care, doctors must assess symptoms thoroughly before prescribing antibiotics. Urine cultures remain the gold standard for diagnosing UTIs, and the guide advocates for their use whenever possible.

Why This Guide is Needed

The guide’s creators—led by Dr. Jennifer Meddings, a primary care physician and patient safety researcher—believe that UTIs are becoming a significant concern due to the rise of antibiotic resistance. As one of the most common reasons for antibiotic prescriptions in the U.S., UTIs require careful management. However, the number of patients receiving treatment through telehealth services, without proper urine testing, has increased the likelihood of misdiagnosis and inappropriate care.

The challenge lies in the fact that many telehealth services allow patients to get antibiotics without ever visiting a clinic or lab. These services often rely on questionnaires or symptom checklists, but without physical exams or lab tests, it is hard to ensure that the treatment prescribed is the correct one.

Guidance for Telehealth Providers and Patients

Empiric Antibiotics: The guide offers some flexibility by allowing the use of empiric antibiotics—prescribing antibiotics based on symptoms—when a patient is unable to access a lab test or lives far from a clinic or testing facility. However, this should be done with caution.
For Frequent UTI Sufferers: The guide advises patients who experience UTIs regularly to always request a urine culture to ensure they are receiving the most appropriate treatment. This is especially important for people who use antibiotics preventatively or after intercourse.
The Future of Virtual Care: While some at-home UTI tests are available on the market, they lack the accuracy required for confirming a UTI. The guide encourages healthcare providers to be cautious about using these at-home tests and advises that professional testing is still the most reliable method.

A Step Towards Better UTI Management

Telehealth has undeniably transformed the landscape of healthcare, removing barriers to treatment like transportation and time constraints. However, with these advancements, there comes a need to refine the processes involved in diagnosing and treating common conditions like UTIs. The Ann Arbor Guide to Triaging Adults with Suspected UTIs is a significant step in helping clinicians strike the right balance between fast, virtual care and ensuring patient safety through proper testing and diagnosis.

The guidelines are already being piloted in Veterans Affairs hospitals during telehealth visits, with the hope of improving UTI management on a national scale. The goal is to provide clinicians and patients with the tools they need to make informed decisions in the ever-evolving landscape of virtual healthcare.

By emphasizing testing and appropriate antibiotic use, this guide aims to reduce the risk of antibiotic resistance and ensure that patients receive the best possible care—whether in person or through telehealth.

Conclusion

As the healthcare system increasingly embraces telehealth, having clear and effective guidelines for managing common conditions like UTIs is more important than ever. This new guide offers a comprehensive and practical approach to ensure that virtual care continues to deliver effective results without compromising patient safety.

New Guide to Improving UTI Care in the Age of Telehealth