BACKGROUND: Uncomplicated lower urinary tract infection (LUTI) is one of the most common infections treated in general practice. Although nationwide treatment guidelines for LUTI are increasingly available, most European countries, including Slovenia, have not yet set such guidelines. OBJECTIVES: Our aim was to describe Slovene GPs' management of uncomplicated LUTIs and to analyse doctor and surgery characteristics that influence this management. METHOD: A written case vignette accompanied by open-ended questions regarding doctors' decisions (i.e. investigations and laboratory tests ordered, treatment options, advising sick leave, advice for treatment and follow-up procedures) and questions about doctor and surgery characteristics was sent to a representative sample of Slovene GPs. RESULTS: The response rate was 129/171 (75.4%). There were large variations in management of LUTI: 17.8% of GPs ordered various additional laboratory tests; 57% of GPs prescribed trimethoprim/sulfamethoxazole and 37% norfloxacin; 30% of GPs prescribed a drug for 10-14 days; and 53.5% of GPs put the patient on sick leave of 1-10 days duration. Doctors with heavier workloads and those who have to wait for laboratory results for >24 h ordered more additional investigations. CONCLUSIONS: Effective strategies for quality improvement are needed, together with practice guidelines. The influence of a heavier workload on management of LUTI and the impact of the accessibility of laboratory tests should be explored in future research.
BACKGROUND: Uncomplicated lower urinary tract infection (LUTI) is one of the most common infections treated in general practice. Although nationwide treatment guidelines for LUTI are increasingly available, most European countries, including Slovenia, have not yet set such guidelines. OBJECTIVES: Our aim was to describe Slovene GPs' management of uncomplicated LUTIs and to analyse doctor and surgery characteristics that influence this management. METHOD: A written case vignette accompanied by open-ended questions regarding doctors' decisions (i.e. investigations and laboratory tests ordered, treatment options, advising sick leave, advice for treatment and follow-up procedures) and questions about doctor and surgery characteristics was sent to a representative sample of Slovene GPs. RESULTS: The response rate was 129/171 (75.4%). There were large variations in management of LUTI: 17.8% of GPs ordered various additional laboratory tests; 57% of GPs prescribed trimethoprim/sulfamethoxazole and 37% norfloxacin; 30% of GPs prescribed a drug for 10-14 days; and 53.5% of GPs put the patient on sick leave of 1-10 days duration. Doctors with heavier workloads and those who have to wait for laboratory results for >24 h ordered more additional investigations. CONCLUSIONS: Effective strategies for quality improvement are needed, together with practice guidelines. The influence of a heavier workload on management of LUTI and the impact of the accessibility of laboratory tests should be explored in future research.
Authors: Linda A M J Huibers; Grete Moth; Gunnar T Bondevik; Janko Kersnik; Carola A Huber; Morten B Christensen; Rüdiger Leutgeb; Armando M Casado; Roy Remmen; Michel Wensing Journal: BMC Fam Pract Date: 2011-05-13 Impact factor: 2.497