The impact of the Hospital Elder Life Program on the treatment of asymptomatic bacteriuria: An unexpected benefit

Abstract

Delirium in older adults is often inappropriately attributed to presumed urinary tract infections (UTIs) leading to unnecessary prescribing of antibiotics for asymptomatic bacteriuria. We sought to examine whether implementation of the Hospital Elder Life Program (HELP), a delirium prevention program, reduced the inappropriate treatment of asymptomatic bacteriuria. We conducted a secondary data analysis of administrative data and electronic health records on a descriptive study in which HELP was implemented at an academic community hospital. Patients aged 70 and older admitted before HELP was implemented (n = 687) were compared to the intervention group after HELP implementation (n = 637). HELP intervention participants, compared to pre-intervention patients, were less likely to receive inappropriate treatment for asymptomatic bacteriuria (3.0% versus 6.7%, adjusted odds ratio=0.46, 95% confidence interval=0.26–0.79, P = 0.005). HELP was associated with a reduction in the treatment of asymptomatic bacteriuria. Therefore, HELP may decrease adverse events and costs related to unnecessary exposure to antibiotics.