Improving care for women with recurrent urinary tract infections: From patient expectations to a possible eHealth solution

Recurrent urinary tract infections (UTIs) are among the most common bacterial infections in women. Between 20–50% of women experience at least one recurrence. This PhD-thesis explores how care for women with recurrent UTIs can be improved, considering the perspectives of patients, general practitioners, and urologists.

Chapter 1 provides background information on the epidemiology, risk factors, and key stakeholders involved. Chapter 2 investigates the expectations of women referred to secondary care. Three main themes emerged: the care pathway, patient knowledge, and social implications. These findings informed the development of a patient survey.

Chapter 3 assesses the quality of international clinical guidelines, concluding that many fall short in several areas. Chapter 4 compares diagnostic practices in two hospitals, showing that routine ultrasound and cystoscopy add limited value. Chapter 5 presents a patient survey revealing that primary care often deviates from guideline-based practice. Although patients frequently expect diagnostic testing, many primarily seek explanations and understanding.

Chapter 6 introduces myRUTIcoach, an eHealth tool designed to support self-management and patient education. The tool was positively received in a feasibility study. Chapter 7 describes the design of a randomized controlled trial to evaluate the effectiveness of myRUTIcoach.

In conclusion, improved education and prevention in primary care are essential. Diagnostic testing should be applied more selectively, and eHealth offers a promising avenue for delivering personalized care to women with recurrent UTIs.