ObjectivesThis study aimed to identify factors associated with long-term urinary catheterisation (LTUC) in community-dwelling older adults and to evaluate the risk of urinary tract infection (UTI) among people with LTUC.DesignPopulation-based observational study.SettingMedical and long-term care insurance claims data from one municipality in Japan.ParticipantsPeople aged ≥75 years living at home who used medical services between October 2012 and September 2013 (n=32 617).Outcome measures(1) Use of LTUC, defined as urinary catheterisation for at least two consecutive months, to identify factors associated with LTUC and (2) the incidence of UTI, defined as a recorded diagnosis of UTI and prescription of antibiotics, in people with and without LTUC.ResultsThe 1-year prevalence of LTUC was 0.44% (143/32 617). Multivariable logistic regression analysis showed that the male sex, older age, higher comorbidity score, previous history of hospitalisation with in-hospital use of urinary catheters and high long-term care need level were independently associated with LTUC. The incidence rate of UTI was 33.8 and 4.7 per 100 person-years in people with and without LTUC, respectively. According to multivariable Poisson regression analysis, LTUC was independently associated with UTI (adjusted rate ratio 2.58, 95% CI 1.68 to 3.96). Propensity score-matched analysis yielded a similar result (rate ratio 2.41, 95% CI 1.45 to 4.00).ConclusionsWe identified several factors associated with LTUC in the community, and LTUC was independently associated with the incidence of UTI.
PMH65 EFFECT OF PRIOR AUTHORIZATION ON ANTIPSYCHOTIC DRUG USE IN LONG-TERM CARE: POPULATION-BASED NATURAL EXPERIMENT