Indwelling Catheter Use in Home Care: Elderly, Aged 65+, in 11 Different Countries in Europe

Objective: To describe possible differences/patterns in the use of indwelling urinary catheters (IUC) in Europe.

Design: A prospective, population-based, assessment study.

Setting: The target population was 4,455 (random sample of 405 from each of 11 countries) aged 65+ receiving home care.

Methods: The clients were assessed by using the Resident Assessment Instrument MDS-HC; epidemiological and medical characteristics of clients and service utilisation were recorded.

Measurements: The frequency of use of IUC related to the patients' activities of daily living (ADL) and cognitive functioning.

Results: The sample consisted of 4,010 informants: 74% female, with mean age 82.3 +/-7.3 years; men 80.9 +/-7.5 years and female 82.8 +/-7.3 years. A total of 216 (5.4%) clients were using IUC. In Italy 23% were using a catheter compared with 0% in The Netherlands. Catheter use was more common in men than in women (11.5% versus 3.3%). Use of IUC was significantly correlated to certain diseases and symptoms and increase in care burden and formal services. Twenty-six per cent of the informants with indwelling catheters scored three or more on a hierarchical ADL scale (0-6). The clients using IUC in the Nordic countries were less dependent on care than in the other European countries. Models built on multivariate analysis explained 37% of the use of IUC. Tradition and attitudes may explain the differences between the sites.

Conclusions: Catheter use is associated with formal or family care burden. The need for nursing home placement ought to be considered in some cases. A stricter criterion for using IUC may be considered in the southern European countries.