Is dementia or a UTI causing confusion? Accurate diagnosis of urine samples is a MUST!
Urine – that often ignored and never spoken about topic! Urine has the ability to inform the medical world about the health and fitness of patients – of you and I, of everyone regardless of age. It is used to diagnose numerous conditions such as urinary tract infection (UTI) and sepsis, both of which you may have heard in storylines from Radio 4’s The Archers and ITV’s Coronation Street. That mainstream drama is bringing these problems to the attention of their audiences highlights the importance of basic clinical diligence.
Yet one in four patients every day will suffer from failed diagnosis because their urine samples are useless. Why? Because the shocking lack of protocol around urine-based diagnostics leads to 14.6m urine samples (of an annual 65m) being unreliable. One of the 59,000 daily failures could impact you or a loved one very directly. Not great news, is it?
The Archers’ story was particularly poignant, as the elderly character concerned was understood to be suffering from confusion, some said dementia, when in reality, once correctly diagnosed from her urine sample, she had a UTI. Without this correct diagnosis, the resulting prognosis and mistreatment could have gone on for months leading to a potentially chronic condition, to blood infection and worse.
Urine and the diagnostics that surround it remain overlooked in today’s clinical world, a situation that a coalition of charities hope to change through the recent launch of the MUST Campaign – Make Urine Samples Trustworthy. MUST calls for a protocol around urine collection and analysis making the most common diagnostic process reliable for the very first time giving it parity with its diagnostic counterpart, blood.
Treatment that’s right first time
The introduction of this protocol will ensure that right-first-time treatment becomes the rule rather than the exception. Inaccurate diagnosis and treatment cost the NHS millions of pounds. Accuracy will deliver a far fewer false-positive specimens, retests and repeat prescriptions and reduce the prescribing of expensive medicines that don’t necessarily help the patient but can encourage the rise of antimicrobial resistance (AMR).
Of particular interest to older readers will be the reality that a definitive pre-assessment that clears the patient of a urine infection will result in fewer expensive cancelled orthopaedic operations. Having much-needed surgery delayed because urine is not collected to a gold standard does not encourage faith in common, basic medical procedures.
When failure to correctly diagnose and treat patients is down to gross inconsistency around existing urine collection methods, unreliable sample quality and an inertia around change, the MUST Campaign has its work cut out.
Reliable protocols to Make Urine Samples Trustworthy
100,000 signatories are needed to bring the MUST petition to debate in Parliament. Almost 5,000 have already signed up. The petition calls on the new Secretary of State for Health and Social Care, the Rt Hon Matt Hancock MP, to introduce a “gold standard” protocol to govern the urine collection process – it’s collection, transportation, and storage to culturing in the lab and the subsequent reporting of results.
A Dr Ali Ased, Consultant Urological Surgeon at Mid Yorkshire Hospitals said recently: “This is an issue that is clearly impacting on our patients and something that they desperately want sorted out. I cannot think of another urological issue, in recent years, that has brought so many varying patient groups and charities together to back it. As advocates for our patients, we have a duty to recognise this and support them. I think most clinicians already know that urine testing is often unreliable. We need standardised, reliable protocols to Make Urine Samples Trustworthy.”
Sign the petition on change.org
Since launch, The Urology Foundation, Bladder Health UK and the MAMA Academy are pleased to have attracted the support of The Patient Association, Bladder and Bowel UK, CUTIC (The Chronic Urinary Tract Infection Campaign), ERIC (Children’s Bowel and Bladder) all of whom have added their voices.
Time, money and resources are squandered on bad urine sample collection
“It really is important for this message to get across”, Louise de Winter, Chief Executive, The Urology Foundation said at the launch. “With the average national contamination rate of urine samples at around 22.5%, it seems wasteful that so much time, money and resources is being squandered on bad sample collection and the need for re-testing as this has a profound effect on patients as well as the NHS. If we can get it right first time, it would not only save the NHS millions, but improve patient care for all of us.”
Suzanne Evans, Chief Executive at Bladder Health UK: “Our team takes many calls on our Advice Line from people of all ages and sexes suffering from painful, debilitating bladder problems that are rooted in poor or slow diagnosis. Evidence is stacking up that something can be done about this and we are glad to be part of a campaign that is giving the patient a voice.”