# Optimizing Management of Urinary Tract Infections in Patients with Neurogenic Bladder through Improved Knowledge of Provider Practice and Patient-reported Outcomes

> **NIH VA IK2** · EDWARD HINES JR VA HOSPITAL · 2020 · —

## Abstract

Project Summary/Abstract
Chronic neurologic injuries and diseases such as spinal cord injury (SCI), multiple sclerosis (MS), and
Parkinson's disease (PD) often cause chronic bladder dysfunction termed `neurogenic bladder' (NB). Over
400,000 people are estimated to be living with NB in the U.S. The VA provides a significant amount of services
for these patient populations, due to its unique focus on coordinated, lifelong care for Veterans with complex,
chronic disabling conditions. Urinary tract infections (UTIs) are common complications in patients with NB and
can cause pyelonephritis, sepsis, kidney stones, and, rarely, death. UTI management is challenging because
bacteria frequently colonize a neurogenic bladder without infection, a situation called “asymptomatic
bacteriuria” (ASB). Furthermore, UTI symptoms are often atypical in patients with NB due to impaired bladder
sensation. Antibiotic treatment of UTIs is critical, however routine treatment of ASB is not beneficial and may
lead to harm. Despite this, many patients with NB due to SCI, MS, and PD are managed improperly with high
rates of unnecessary and/or inappropriate antibiotic use. [Improper UTI management directly impacts patient
rehabilitative health, functioning, and quality of life via the long-term and profound adverse consequences of
antibiotic resistance and antibiotic overuse.] However, the association of UTI management with patient-
reported rehabilitation outcomes has not been well-studied or clearly delineated.
 Support from the CDA2 will provide Dr. Fitzpatrick with the necessary foundation for a successful career as
a VA [rehabilitation researcher focused on implementing interventions to improve Veteran rehabilitative health
by optimizing infectious diseases management and antibiotic use in patients with NB due to complex, chronic
neurologic injuries and diseases.] Appropriate UTI management and avoidance of unnecessary antibiotics is
critical to ensure the delivery of high quality, safe care for these high-priority patients. This innovative project
will study a cohort of patients with NB [due to SCI, MS, and PD] cared for at a range of VA hospitals of varying
geographic locations and sizes. It aims to characterize variations in care provided for ASB and UTI and
associate them with key provider and patient characteristics using a retrospective cohort study with electronic
health record data. It further aims to use qualitative methods to assess patient knowledge, attitudes, beliefs,
and expectations regarding ASB and UTI and measure UTI-related patient-reported rehabilitation outcomes. In
this way, the project represents a critical step forward in developing a patient-centered approach to ASB and
UTI management. Results from this project will be used to support Dr. Fitzpatrick's VA Merit Review
application to develop a multimodal patient-centered intervention to [improve functional and patient-reported
rehabilitation outcomes via improved ASB and UTI management in patients ...

## Key facts

- **NIH application ID:** 9833352
- **Project number:** 1IK2RX002826-01A2
- **Recipient organization:** EDWARD HINES JR VA HOSPITAL
- **Principal Investigator:** Margaret A Fitzpatrick
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-01-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9833352

## Citation

> US National Institutes of Health, RePORTER application 9833352, Optimizing Management of Urinary Tract Infections in Patients with Neurogenic Bladder through Improved Knowledge of Provider Practice and Patient-reported Outcomes (1IK2RX002826-01A2). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9833352. Licensed CC0.

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