CATHETER II study: randomised controlled trial comparing the clinical and cost-effectiveness of various washout policies versus no washout policy in preventing catheter associated complications in adults living with long-term catheters

Urinary catheters are soft tubes inserted into the bladder to drain urine to a collection bag or valve. Current best practice for LTC care includes educating patients on how to look after their catheter. Patients normally change their catheter bag every week while the catheter itself is changed by a nurse every 10-12 weeks. Despite this, complications such as blockages, urinary tract infections and urinary incontinence can occur with LTC use. Blockages are one of the most common complications, and can lead to urine retention, incontinence, severe pain, anxiety and the need for an emergency catheter change.
There are two broad strategies to deal with the prevention and management of catheter blockage: more frequent change of the catheter and/or the use of liquid washout solutions to flush the catheters. LTC washouts are widely used in clinical practice to prevent LTC blockage but there is limited evidence to recommend their widespread use or stoppage. In CATHETER II, participants with a LTC are being randomised to receive standard catheter care with or without weekly catheter washouts (citric acid or saline). The alternative policies will be compared on a range of outcome measures, including the number of catheter blockages; catheter-associated urinary tract infections; health-related quality of life; and costs incurred by patients and NHS.

HERU researchers involved in this research project: Graham Scotland and Mary Kilonzo

External collaborators: Abdel-Fattah, M., N'Dow, J., Murchie, P., MacLennan, S., Myint, P., Omar, I. (Institute of Applied Health Sciences, University of Aberdeen); MacLennan, G. (Health Services Research Unit (HSRU), University of Aberdeen).