OBJECTIVES: To characterise the burden of long-term intermittent catheter (IC) use in the United Kingdom.

METHODS: This was a retrospective cohort study using the Clinical Practice Research Datalink-Hospital Episode Statistics linked database (January 1, 2011-December 31, 2020). Eligible patients were ≥18 years old with long-term IC use (≥3 IC prescriptions in primary care within consecutive intervals of ≤4 months; ≥6 months total duration), matched 1:5 on age/sex with non-catheterising individuals from the general population. Patient characteristics, occurrence of urinary tract infections (UTIs), health care resource use (HCRU) and costs were analysed up to 1 year from the first eligible IC prescription and compared using Fisher’s Exact Test or Wilcoxon Rank Sum Test.

RESULTS: A total of 3,520 IC users and 15,643 controls had mean ages of 61 years each; 61% and 57% were men, 94% and 71% were white, respectively. Among IC users, “UTI, site not specified” was the most common reason for general practitioner (GP) visits; chronic kidney disease was the most common reason for hospitalisation. Mean all-cause healthcare costs (GP visits, hospitalisations, outpatient and emergency department visits) were £4,710 for IC users and £1,498 for controls (P<0.001). Most IC users (70%) had UTI-related antibiotic prescriptions (mean, 4.24), though only 30% had UTI recorded diagnoses, compared with 21% of controls with UTI-related antibiotic prescriptions (mean, 0.40) and 4% with UTI diagnoses (all P<0.001). UTI-related HCRU was approximately 10 times greater among IC users (GP visits, 26% vs 3%; hospitalisations, 5% vs 0.4%; 30-day readmissions, 0.5% vs <0.1%). Mean UTI-related healthcare costs were £76.31 vs £7.61 among IC users and controls, respectively (P<0.001). Hospitalisations and outpatient visits accounted for 76% of UTI-related costs among IC users.

CONCLUSIONS: Long-term IC users incur substantially more HCRU and related costs than controls, driven by hospitalisations and antibiotic prescriptions, particularly for UTI-related care.