Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands
Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands.
BMJ Open. 2024 Oct 26;14(10):e083263. doi: 10.1136/bmjopen-2023-083263.
Urinary tract infections (UTIs) are the most common reason for women to consult a general practitioner (GP). Current diagnostic tests are inadequate, complicating diagnosis and treatment decisions for GPs. To understand how this influences GPs in managing UTI, we aimed to determine GPs' knowledge, attitudes, and practices around UTI care.
Cross-sectional internet-based survey.
General practice in the Netherlands between December 2021 and February 2022.
We distributed invitations to participate via email to 126 practices. Additionally, we distributed invitations via social media and newsletters.
The survey included 15 questions covering GPs' sociodemographic information, knowledge, attitudes and practices. Data analysis was based on frequencies and descriptive statistics.
Among the 190 eligible respondents, 172 (90.5%) chose dysuria and 140 (73.7%) chose urinary frequency as a symptom likely indicating UTI in healthy women. One in three GPs would diagnose a UTI based on non-specific complaints with positive leucocyte and erythrocyte tests, discordant with established guidelines. GPs indicated that better point-of-care diagnostics would help improve antibiotic prescribing (72.6%) and would conserve time (60.0%). GPs considered a positive test result the most important factor to prescribe antibiotics while patient expectation was considered least important. Half of GPs indicated that the most urgent need in UTI care is improved diagnostics.
GPs often act in discordance with established guidelines, rely on non-specific symptoms for the diagnosis of UTI and rank patient expectation as less important in comparison to symptom recognition and culture result when deciding on antibiotic treatment.
尿路感染(UTI)是女性就诊全科医生(GP)最常见的原因。目前的诊断测试并不完善,这使得 GP 对 UTI 的诊断和治疗决策变得复杂。为了了解这如何影响 GP 对 UTI 的管理,我们旨在确定 GP 对 UTI 护理的知识、态度和实践。
基于互联网的横断面调查。
荷兰全科医学实践,2021 年 12 月至 2022 年 2 月。
我们通过电子邮件向 126 个实践发送了参加邀请。此外,我们还通过社交媒体和通讯进行了邀请。
该调查包括 15 个问题,涵盖了 GP 的社会人口统计学信息、知识、态度和实践。数据分析基于频率和描述性统计。
在 190 名符合条件的受访者中,172 名(90.5%)选择尿痛,140 名(73.7%)选择尿频作为健康女性可能表明 UTI 的症状。三分之一的 GP 会根据白细胞和红细胞测试阳性的非特异性投诉诊断 UTI,这与既定指南不符。GP 表示,更好的即时诊断有助于改善抗生素处方(72.6%)并节省时间(60.0%)。GP 认为阳性测试结果是开具抗生素的最重要因素,而患者期望则被认为是最不重要的因素。半数 GP 表示 UTI 护理最紧迫的需求是改善诊断。
GP 经常与既定指南不符,依赖非特异性症状诊断 UTI,在决定抗生素治疗时,与症状识别和培养结果相比,患者期望的重要性较低。