The decision which type of urinary catheter to prescribe should be made on individual basis, taking into account the patient’s individual needs and circumstances. However, the current decision-making process is not transparent or standardized.(1) The objective of this study was to identify the decision-making process of healthcare providers in the Netherlands when prescribing or managing urinary catheters, to improve the standard of care and ultimately the patient satisfaction.

A survey study was conducted between August and September 2024 at urology departments and rehabilitation centers across the Netherlands. Participants included urologists, rehabilitation doctors, (continence) nurses, and physician assistants (PAs). The questionnaire, developed during a structured consensus meeting by a group of urologists, PAs, and (continence) nurses, consisted of 12 questions.

The survey was sent to 300 healthcare providers of whom 108 filled in the survey (response rate 36%). 49 (45%) were (continence)nurse, 46 (43%) were urologist, 9 (9%) were PA, and 6 (6%) were rehabilitation doctor. 57% participants see more patients with an IDC. 83% participants prefer CIC and 17% have no specific preference. 93% and 73% of the respondents based their decision on the patient characteristics and the diagnosis. (Continence)nurses were least often involved in the decision-making process, when involved 53% did not discuss potential other treatment options. 79% and 64% of the respondents discussed medication and deobstruction as other treatment options.

We observed differences in the decision-making processes among healthcare providers when prescribing urinary catheters. Not all healthcare providers are equally involved in the decision-making process, and they base their decisions on different factors. This variability can lead to discrepancies in the treatment options discussed with patients and the information provided to them, ultimately affecting the treatment they receive. As a result, patients may not be presented with the best options for their individual needs, potentially limiting their patient satisfaction.

To optimize bladder management treatment, the decision-making process should incorporate shared decision-making (SDM). Implementing SDM promotes patient autonomy and can increase patient satisfaction with their bladder management. To minimize variability among healthcare providers and facilitate SDM, comprehensive training supplemented with a validated decision aid may present a promising solution. A decision aid can help inform patients and clarify the decision-making process, enabling better collaboration between patients and healthcare providers in selecting the most appropriate type of bladder management .

van Veen FEE, Scheepe JR, Blok BFM. Regional variation in urinary catheter use in the Netherlands from 2012 to 2021: a population-based cohort. Ther Adv Urol. 2023;15:17562872231215181.