Astonishing results

Peezy was developed in response to patient feedback to address the hygiene and dignity issues complained of by patients. Evidence of reduced contamination of urine samples was found later.

Our UK and US customers have found reduced contamination, and savings in reduced retesting, overall expenditure, and antibiotic prescribing due to improved accuracy of diagnosis. Device failure is almost unknown. A recent anecdotal report from a US distributor states: ‘Some lab employees and the supervisor stated they had previously taken Peezy home for personal use. The lab supervisor felt Peezy was “indestructible”, and she was unable to get it to fail.’

Had we experienced the massive 25% device failure rate quoted, we would never have launched the product. We provide training for staff issuing Peezy. In turn, first-time users are correctly instructed in its use. Other than device supply, we were excluded from any involvement in the study, so this was not possible.

We wrote to the principal author asking to clarify if Peezy patients were asked to ensure a full bladder before sampling but this specific question was not answered. We cannot verify that Peezy was used correctly. The authors admit that the Peezy failure rate may have affected the analysis. ‘About a quarter of Peezy UCDs [urinary collection devices] failed, and this may have impacted the intention-to-treat analysis.’¹

As a small to medium-sized enterprise we are unable to fund large clinical trials and rely on smaller independent studies. However, a reduction in contamination rates has been widely reported.^2–7

Llor comments: ‘We certainly do not know how patients collect the urine samples despite being instructed to perform midstream urine sample collection.’⁸ Peezy standardises urine sampling. The National Institute for Health and Care Excellence says of Peezy: ‘The device is the only urine collection method that meets Public Health England’s UK Standards for Microbiology Investigations: Investigation of urine.’⁹

The astonishing failure rate is unprecedented, and points to inadequate instruction. The absence of sample contamination reduction contradicts the evidence given to us. We do not accept the results of this study, which is at odds with the clear satisfaction of our customers and their end users.

• © British Journal of General Practice 2022