Factors affecting continuation of clean intermittent catheterisation in people with multiple sclerosis: results of the COSMOS mixed-methods study

Doreen McClurg*, Carol Bugge, Andrew Elders, Tasneem Irshad, Suzanne Hagen, Katherine N. Moore, Brian Buckley, Mandy Fader

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background: Clean intermittent catheterisation (CIC) is often recommended for people with multiple sclerosis (MS). Objective: To determine the variables that affect continuation or discontinuation of the use of CIC. Methods: A three-part mixed-method study (prospective longitudinal cohort (n = 56), longitudinal qualitative interviews (n = 20) and retrospective survey (n = 456)) was undertaken, which identified the variables that influenced CIC continuation/discontinuation. The potential explanatory variables investigated in each study were the individual’s age, gender, social circumstances, number of urinary tract infections, bladder symptoms, presence of co-morbidity, stage of multiple sclerosis and years since diagnosis, as well as CIC teaching method and intensity. Results: For some people with MS the prospect of undertaking CIC is difficult and may take a period of time to accept before beginning the process of using CIC. Ongoing support from clinicians, support at home and a perceived improvement in symptoms such as nocturia were positive predictors of continuation. In many cases, the development of a urinary tract infection during the early stages of CIC use had a significant detrimental impact on continuation. Conclusion: Procedures for reducing the incidence of urinary tract infection during the learning period (i.e. when being taught and becoming competent) should be considered, as well as the development of a tool to aid identification of a person’s readiness to try CIC.
Original languageEnglish
Pages (from-to)727-739
Number of pages13
JournalMultiple Sclerosis Journal
Volume25
Issue number5
Early online date23 Apr 2018
DOIs
Publication statusPublished - 1 Apr 2019

Keywords

  • quality of life
  • rehabilitation
  • symptomatic treatment
  • clean intermittent catheterisation
  • multiple sclerosis
  • CIC

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