Mixed-Methods Analysis of Provider-Documented and Patient-Reported Urinary Tract Infection Symptoms Among Veterans With Neurogenic Bladder.

Inappropriate urinary tract infection diagnosis in patients with neurogenic bladder may result from ambiguous symptoms experienced by these patients and contributes to antibiotic overuse. Characterization of patient-reported signs and symptoms may help providers more appropriately diagnose urinary tract infections. A previous study collected signs and symptoms recorded in electronic medical records of patients with neurogenic bladder due to spinal cord injury/disorder, multiple sclerosis, and Parkinson's disease with at least one urinary tract infection diagnosis between 2017-2018 at four medical centers.

Knowledge, perceptions, and beliefs about urinary tract infections in persons with neurogenic bladder and impacts on interventions to promote person-centered care.

Study Design: Qualitative study.

Objectives: To explore how knowledge, perceptions, and beliefs about urinary tract infections (UTIs) among persons with neurogenic bladder (NB) may impact health behaviors and provider management and enhance person-centeredness of interventions to improve UTI management.

Setting: Three Veterans Affairs (VA) medical centers.

Perceptions, experiences, and beliefs regarding urinary tract infections in patients with neurogenic bladder: A qualitative study.

Although urinary tract infections (UTIs) are common in patients with neurogenic bladder (NB), limited data exist on UTI perceptions, experiences, and beliefs in these patients. We recruited adults with NB due to spinal cord injury/disorder (SCI/D) or multiple sclerosis (MS) at three Veterans Affairs (VA) medical centers to participate in 11 virtual focus groups. Audio transcripts were coded using a mixed approach with primary deductive codes linked to the Health Belief Model, and secondary inductive codes informed by grounded theory.

Management of Asymptomatic Bacteriuria and Urinary Tract Infections in Patients With Neurogenic Bladder and Factors Associated With Inappropriate Diagnosis and Treatment.

Objective: Inappropriate diagnosis and treatment of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) are leading causes of antibiotic overuse but have not been well-studied in patients with risks for complicated UTI such as neurogenic bladder (NB). Our aim was to describe ASB and UTI management in patients with NB and assess factors associated with inappropriate management.

Design: Retrospective cohort study.

Collaborative Care Versus Usual Care to Improve Quality of Life, Pain, Depression, and Physical Activity in Outpatients With Spinal Cord Injury: The SCI-CARE Randomized Controlled Clinical Trial.

Our goal was to test the effectiveness of collaborative care (CC) versus usual care (UC) to improve treatment of pain, depression, physical inactivity, and quality of life in outpatients with spinal cord injury (SCI). We conducted a single blind parallel group randomized controlled trial. The setting was two outpatient SCI rehabilitation clinics within a large academic medical center.

Risk Factors for Chronic Prescription Opioid Use in Multiple Sclerosis.

Objective: To characterize patterns of prescription opioid use among individuals with multiple sclerosis (MS) and identify risk factors associated with chronic use.

Design: Retrospective longitudinal cohort study examining US Department of Veterans Affairs electronic medical record data of Veterans with MS. The annual prevalence of prescription opioid use by type (any, acute, chronic, incident chronic) was calculated for each study year (2015-2017).

Retrospective Cohort Study of Patient-Reported Urinary Tract Infection Signs and Symptoms Among Individuals With Neurogenic Bladder.

Objective: The aim of the study is to characterize patient-reported signs and symptoms of urinary tract infections in patients with neurogenic bladder to inform development of an intervention to improve the accuracy of urinary tract infection diagnosis.

Design: This is a retrospective cohort study of adults with neurogenic bladder due to spinal cord injury/disorder, multiple sclerosis, and/or Parkinson disease and urinary tract infection encounters at four medical centers between 2017 and 2018. Data were collected through medical record review and analyzed using descriptive statistics and unadjusted logistic regression.

Modernization of a Large Spinal Cord Injuries and Disorders Registry: The Veterans Administration Experience.

Since the 1990s, Veterans Health Administration (VHA) has maintained a registry of Veterans with Spinal Cord Injuries and Disorders (SCI/Ds) to guide clinical care, policy, and research. Historically, methods for collecting and recording data for the VHA SCI/D Registry (VSR) have required significant time, cost, and staffing to maintain, were susceptible to missing data, and caused delays in aggregation and reporting. Each subsequent data collection method was aimed at improving these issues over the last several decades.

Vital sign differences between septic patients with tetraplegia and paraplegia.

Study Design: Retrospective chart review.

Objectives: Sepsis is a leading preventable cause of death in patients with chronic spinal cord injury (SCI). Individuals with tetraplegia may exhibit different signs and symptoms of infection compared to those with paraplegia.

Positive predictive value of a sepsis-screening protocol for patients with tetraplegia.

Objective: To determine the positive predictive value (PPV) of a sepsis-screening protocol in patients with cervical spinal cord injury (SCI).

Design/method: Retrospective review of all patients with cervical SCI who screened positive for two or more systemic inflammatory response syndrome (SIRS) criteria while hospitalized in acute care or inpatient rehabilitation units over a 3.5-year period.

Current and projected workforce of spinal cord injury medicine board-certified physicians through 2040.

Care delivered by physicians experienced and trained in spinal cord injury medicine (SCIM) offers benefit to individuals with spinal cord injury (SCI). The American Board of Physical Medicine and Rehabilitation (ABPMR) offers board certification (BC) to physicians who have met eligibility requirements. Enough individuals must earn and maintain BC in order to maintain a SCIM specialty-trained workforce.

Limb loss in individuals with chronic spinal cord injury.

: The purpose of this study is to describe a population of individuals with chronic spinal cord injury (SCI), who underwent lower limb amputations, identify indications for amputations, medical co-morbidities and summarize resulting complications and functional changes.: Retrospective observational cohort study. SCI Service, Department of Veterans Affairs (VA) Health Care System.

Comparing 4- and 6-week post-flap protocols in patients with spinal cord injury.

For patients with spinal cord injury (SCI) who undergo flap surgery to treat pressure injuries (PIs), the optimal duration of post-operative bedrest to promote healing and successful remobilization to sitting is unknown. At the study center, the minimum duration of post-operative bedrest was changed from 4 to 6 weeks. The purpose of this study is to compare outcomes of patients who underwent flap surgery using bedrest protocols of different duration.

Multidrug-resistant gram-negative organisms and association with 1-year mortality, readmission, and length of stay in Veterans with spinal cord injuries and disorders.

Study Design: Retrospective cohort study.

Objectives: The goal of this study was to assess the impact of multidrug resistant gram-negative organisms (MDRGNOs) on outcomes in those with SCI/D.

Setting: VA SCI System of Care, Department of Veterans Affairs, United States.

Healthcare facility-onset, healthcare facility-associated infection in Veterans with spinal cord injury and disorder.

To describe the burden and risk of healthcare facility-onset, healthcare facility-associated (HO-HCFA) infection (CDI) in Veterans with spinal cord injury and disorder (SCI/D). Retrospective, longitudinal cohort study from October 1, 2001-September 30, 2010. Ninety-four acute care Veterans Affairs facilities.

Employment, health outcomes, and life satisfaction after spinal cord injury: comparison of veterans and nonveterans.

Study Design: Retrospective cohort study.

Objective: To explore differences between veterans and nonveterans with spinal cord injury (SCI) for employment, health, and satisfaction with life outcomes after controlling for demographic and injury characteristics.

Setting: Hospitals in the Spinal Cord Injury Model System of care.

Urinary tract infections and bladder management over the first year after discharge from inpatient rehabilitation.

Study Design: Secondary analysis of data from a prospective clinical trial of telephone counseling.

Objectives: To describe changes in bladder management and development of bladder-related complications in the first year after discharge from inpatient spinal cord injury (SCI) rehabilitation. To determine whether urinary tract infection (UTI) is associated with bladder management technique or severity of SCI during this time period.