Ruth’s Lockdown Project: Home MSU test kit

According to national hospital data for 2018-2019, nearly one in five people with MS had an emergency hospital admission, and the rates for emergency admissions have been on the rise as other health services have come under pressure. 10% of emergency admissions to hospital for people with MS are due to a urine infection (UTI), and once in hospital they tend to stay for an average of around 7 days. 

People with MS may need a mid-stream urine test (MSU test) when a UTI is suspected, such as if they notice new or worsening symptoms, or to rule out a possible relapse. By diagnosing and treating UTIs earlier, complications and hospital admissions can be avoided. The MSU testing process is quite straightforward but getting a MSU test normally involves visiting a GP or MS nurse who will hand out the equipment and read the result.

Ruth noted that reducing unnecessary face-to-face contact was important during the pandemic, in order to keep patients and health professionals safe. However, people with MS who were self-isolating or shielding still needed to identify a urine infection promptly. Working with the MS Academy and the MS Trust, Ruth developed a postable home MSU test kit, tested it and rolled it out, all between March and July 2020.

The kit consists simply of:

  • a urine collection pot or disposable cardboard bedpan, (40p)
  • a urine specimen container, (50p)
  • 5 dipsticks for urine testing (£2.75)
  • a cover letter to the patient,
  • and a set of clearly written instructions.

The costs indicated above assume that the elements are not purchased in bulk as part of an NHS contract. If you can do this, you may be able to bring the price of a test kid down. Allowing for postage and packaging costs will be determined in part by the size of the urine collecting pot you select. However, it is clear that the Home MSU kit is simple, cheap and adaptable for use in a variety of situations.

In practice, Ruth now sends the Home MSU kit out in the post to patients that indicate that they may be at high risk of admission for a UTI. Post-pandemic, health professionals making home visits have also been able to take the kits to vulnerable patients.

Patients complete the test and email the results to a generic email address that is checked 5 days a week. They can include photos of the test strips if they wish. The results are reported back to their GP or neurologist as required and an MSU is kept & sent off if indicated. The process does require good local links with GPs. Patients are signposted to OOH services if required.

Patients using the new kit gave enthusiastic feedback. One patient said, “I would prefer to do the test at home at the moment, rather than having to visit a hospital or Doctor’s surgery but it is more comforting to have a professional check the results.” Another said, “The test was easy enough to administer. Overall, the remote testing is an emphatic thumbs up.”

If you are interested in developing a similar kit for your own service, you can review the documents that Ruth developed and amend them to suit your own needs.