Capella FPX 4025 Assessment 1

Name

Capella University

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Analyzing a Research Paper

DOI: https://doi.org/10.1186/s12913-023-10234-y

Article Review

Criteria	Review
Type of Study	Quantitative health economic analysis using cost-effectiveness modeling and epidemiological data from seven countries. Based on real-world prevalence, healthcare resource use, and intervention outcomes related to increased daily water intake in women with recurrent urinary tract infections (rUTIs).
Level of Evidence	Level II (Well-designed cohort study/economic modeling study) supported by previously published Level I randomized controlled trials, particularly the pivotal trial by Hooton et al. (2018) on water intake and rUTI reduction.
Methodology	Comparative cost-effectiveness analysis estimating the health and economic impact of increasing daily water intake by 1.5 liters in premenopausal women with rUTIs. Outcomes modeled include reductions in UTI episodes, antibiotic prescriptions, and healthcare visits. Data sourced from public healthcare databases, published trials, and cost metrics in seven countries (US, UK, France, Germany, Italy, Spain, and Sweden).
Credibility Factors	Published in a peer-reviewed journal (Frontiers in Public Health). Authors are affiliated with credible institutions in public health, urology, and pharmacoeconomics. Transparent methodology with limitations acknowledged; no major conflicts of interest reported.
Importance of Selected Diagnosis	Highly relevant to Beulah Roush’s diagnosis of recurrent UTI and dehydration: Supports increased hydration as a primary, non-pharmacologic intervention. Demonstrates a significant reduction in UTI recurrence with daily water intake of 1.5 L or more. Aligns with clinical emphasis on hydration in preventing infection recurrence, especially in older, vulnerable populations.
Application in Workplace/Patient Population	Offers evidence-based justification for recommending increased fluid intake in elderly or long-term care patients prone to rUTIs. Supports care plans promoting hydration to reduce infections, antibiotic use, and hospital visits. Provides economic rationale to advocate for preventive strategies in healthcare settings managing chronic, infection-prone populations like Beulah.

Sentinel U Patient Case Study

Patient Name: Beulah Roush

Diagnosis of Medical Issue: UTI (urinary tract infection) secondary to dehydration

Current Treatment: Currently taking ciprofloxacin (antibiotic for UTI), receiving IV fluids (for dehydration)

Care Plan: While cystitis (UTI) is not life-threatening, untreated cases can lead to pyelonephritis (kidney infection) or sepsis.

Summary of Findings

The article of Costa et al. (2023) shows that by a substantial increase in daily water intake by 1.5L, the incidences of recurrent urinary tract infections (rUTIs) in women, especially the premenopausal and the postmenopausal women who suffer from frequent UTIs, can be reduced. The evidence suggests that increasing daily water intake by 1.5 liters can reduce rUTI recurrence by nearly 50%. Building on previous clinical trial information and real-world epidemiology numbers, the economic model predicts significant decreases in the number of UTI-related health care encounters, antibiotic use, and related costs for seven high-income countries (the United States, the United Kingdom, France, Germany, Italy, Spain, and Sweden).

The analysis shows that a simple behavioral change, increasing hydration, delivers both clinical and cost savings with the potential savings for healthcare worldwide annually in the hundreds of thousands to millions of dollars on a country-by-country basis. The findings uphold the use of hydration as a cost relationship, low-risk metric to prevent UTI recurrence and lessen the burden on health systems globally.

Relevance and Potential Effectiveness of Evidence

This article by Costa et al. (2023) is of extreme relevance to rUTI management and prevention, specifically in older adults or people at risk from dehydration, a patient case such as Beulah Roush. The evidence, from economic modeling of previously validated clinical trials, implies that evidence-based intervention that increases water intake is a simple, non-pharmacological intervention with measurable efficacy in rUTI reduction. Crossing seven countries, the intervention led to a projected cost savings of up to $4,429,882 annually in the U.S. alone. Antibiotic use was also significantly reduced, by 36%, lowering the risk of resistance. Not itself a randomized controlled trial, the article rests on high-level evidence and offers a convincing, cost-effective strategy to pair with existing treatment guidelines and achieve better patient results in inpatient and outpatient contexts.

Article Link

https://doi.org/10.1186/s12913-023-10234-y

References

Costa, J., Iroz, A., Vecchio, M., Roze, S., & Lotan, Y. (2023). Water intake and recurrent urinary tract infections prevention: Economic impact analysis in seven countries. BioMed Central Health Services Research, 23(1). https://doi.org/10.1186/s12913-023-10234-y

Capella FPX 4025 Assessment 1

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