Computer-Assisted Treatment of Urinary Tract Infection in Emergency Departments and Community Health Centers (UTI-Kiosk)

Computer-Assisted Treatment of Urinary Tract Infection in Emergency Departments and Community Health Centers

Computer-Assisted Treatment in the Management of Adult Female Patients With Symptoms of Urinary Tract Infection in Emergency Departments and Community Health Centers: A Randomized Trial

Our study aims to test the utility of computer-assisted treatment for uncomplicated, recurrent urinary tract infections (UTIs) for women receiving care in safety net health care facilities. As of November 2009, we are also testing the utility of computer-assisted treatment for certain types of complicated cystitis (i.e. women with voiding symptoms and one of the following complicating symptoms: fever, flank pain, or symptoms greater than 7 days).

An English version of the UTI Kiosk module was validated at UCSF urgent care clinic in 2005, and has been successfully integrated into the clinical work flow at this clinic for over 2 years. The computer-based module is housed in a freestanding kiosk with a touch-screen monitor and audio handset to allow patients with low literacy and minimum computer skills to complete the module. A printer in the kiosk provides a summary of the patient's responses to each question in the module, as well as a prescription for the clinic physician to sign and return to the patient. It's important to emphasize that the computer only "fast-tracks" women who will be treated with antibiotics. All other women see the provider as usual. Also, all women who are eligible for computer treatment may opt to see a provider instead.

Qualified for expedited treatment for uncomplicated cystitis but would receive usual care in the Emergency Department of Community Health Center.

Would receive expedited treatment for complicated cystitis with longer antibiotic course than the simple UTI patients.

Qualified for expedited treatment for complicated cystitis treatment but would receive usual care in the clinic or emergency department.

This group will receive computer-assisted expedited treatment for uncomplicated UTI or complicated cystitis based on their symptoms and past medical history reported on the computer.

This group will receive usual care for an uncomplicated UTI or complicated cystitis in the Emergency Department or Community Health Center.

Inclusion Criteria: Female 18-64 years old Exclusion Criteria: Below 18 or Above 64 Male New flank pain severe vomiting High blood sugar or diabetes surgery on kidneys chronic kidney disease Previous cancer or chemotherapy HIV or AIDS pregnant or suspected pregnancy