Department of Internal Medicine, Amsterdam UMC location University of Amsterdam, Infectious Diseases, Room no. D3-226, Meibergdreef 9, 1105 AZ, Amsterdam, North-Holland, the Netherlands.
Capgemini Invent, PO box 2575, 3500 GN, Utrecht, Utrecht, the Netherlands.
BMC Prim Care. 2022 Oct 5;23(1):259. doi: 10.1186/s12875-022-01867-9.
Urinary tract infections (UTIs) are common, especially among women. Antibiotics are commonly used to treat UTIs, but might not always be necessary, for example in the case of uncomplicated UTIs such as cystitis. Shared decision making (SDM) could reduce the risk of unnecessary antibiotic prescriptions for uncomplicated cystitis. We investigated the current management and the use of SDM for uncomplicated cystitis in primary care.
We performed a qualitative semi-structured interview study among 23 women with a history of cystitis, 12 general practitioner (GP) assistants, and 12 GPs in the Netherlands from July to October 2020. All interviews were individually performed by telephone. The data were analyzed through the use of using open and axial coding.
The GP assistants managed the initial diagnostics and treatment of uncomplicated cystitis in all general practices. Usually, antibiotics were considered the standard treatment of cystitis. In most general practices, SDM was not used in the treatment of uncomplicated cystitis, mainly because of a lack of time. Women reported that they valued being involved in the treatment decision-making process, but they were not always involved. Further, both GP assistants and GPs indicated that SDM would improve the care pathway of uncomplicated UTIs.
In our study, SDM was infrequently used to help women with uncomplicated cystitis. To reduce the use of antibiotics for uncomplicated UTIs, a tailored intervention is needed to implement SDM for the treatment of uncomplicated cystitis in primary care.
尿路感染（UTI）很常见，尤其是在女性中。抗生素常用于治疗 UTI，但在某些情况下可能并非必需，例如在简单的 UTI（如膀胱炎）中。共同决策（SDM）可以降低不必要的抗生素处方用于治疗简单膀胱炎的风险。我们调查了初级保健中治疗简单膀胱炎的当前管理和 SDM 的使用情况。
我们于 2020 年 7 月至 10 月在荷兰对 23 名有膀胱炎病史的女性、12 名全科医生助手和 12 名全科医生进行了定性半结构式访谈研究。所有访谈均通过电话单独进行。通过使用开放式和轴向编码对数据进行分析。
全科医生助手在所有的全科医生诊所中管理简单膀胱炎的初始诊断和治疗。通常，抗生素被认为是膀胱炎的标准治疗方法。在大多数全科医生诊所中，SDM 并未用于治疗简单膀胱炎，主要是因为缺乏时间。女性报告说她们重视参与治疗决策过程，但并非总是如此。此外，全科医生助手和全科医生都表示，SDM 将改善简单 UTI 的护理路径。
在我们的研究中，SDM 很少用于帮助患有简单膀胱炎的女性。为了减少简单 UTIs 抗生素的使用，需要进行量身定制的干预，以在初级保健中实施 SDM 治疗简单膀胱炎。
