Activity impairment, health-related quality of life, productivity, and self-reported resource use and associated costs of uncomplicated urinary tract infection among women in the United States

BACKGROUND: Uncomplicated urinary tract infections (uUTIs) are among the most common infections in the US. Only a few studies, however, describe the impact of uUTIs from the patient perspective. METHODS: A cross-sectional online survey of US women aged ≥18 years was performed assessing uUTI burden regarding activity impairment, health-related quality of life (HRQoL), workplace productivity, healthcare resource use (HRU), and costs. Participants who self-reported a uUTI in the prior 60 days treated with ≥1 oral antibiotic were included. Activity impairment was assessed with the Activity Impairment Assessment scale. HRQoL was assessed using a modified Short Form 36 (SF-36). Direct costs were sum of out-of-pocket expenditures and monetized HRU; indirect costs were calculated using Work Productivity and Activity Impairment (WPAI). Participants were stratified by uUTI recurrence, number of prescribed antibiotics for recent uUTI and therapy appropriateness (1 first-line/1 second-line/multiple antibiotics). Multivariable regression analysis assessed the relationship between stratifications and outcomes while controlling for demographic/clinical characteristics. Propensity score matching was used to compare participants to a matched population from the 2020 National Health and Wellness Survey (NHWS), to control for any impact of COVID-19 on responses. RESULTS: Among 375 participants, impaired activities included sexual intercourse (66. 9%), sleep (60. 8%) and exercise (52. 3%). HRQoL was worse (p<0. 0001) than the NHWS population (46. 4 vs. 51. 3 physical component score; 40. 0 vs. 46. 9 mental component score; 0. 63 vs. 0. 72 health utility index). All included WPAI assessments were worse for uUTI cohort vs. NHWS (p<0. 0001). Adjusted direct costs were higher for participants receiving 2 vs. 1 antibiotic (2090 vs. 776; p<0. 0001) and receiving multiple antibiotics vs. 1 first-line (1642 vs. 875; p = 0. 002). Recurrent uUTI was associated with increased activity impairment, worse HRQoL, and costs vs. non-recurrent. CONCLUSIONS: uUTIs were associated with increased activity impairment, worse productivity, and reduced HRQoL. Higher costs were found vs. a matched population.