Sarah Milosevic1, Natalie Joseph-Williams2, Bethan Pell3, Elizabeth Cain2, Robyn Hackett2, Ffion Murdoch2, Haroon Ahmed2, A Joy Allen4,5, Alison Bray5,6, Samantha Clarke7, Marcus J Drake8, Michael Drinnan5,6, Kerenza Hood9, Tom Schatzberger10, Yemisi Takwoingi11, Emma Thomas-Jones9, Raymond White12, Adrian Edwards2, Chris Harding13. 1. Centre for Trials Research, Cardiff University, Cardiff, UK. MilosevicS@cardiff.ac.uk. 2. PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK. 3. Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK. 4. NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle University, Newcastle upon Tyne, UK. 5. Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK. 6. Northern Medical Physics and Clinical Engineering, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK. 7. North Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol, UK. 8. Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. 9. Centre for Trials Research, Cardiff University, Cardiff, UK. 10. Corbridge Health Centre, NHS Northumberland Clinical Commissioning Group, Newcastle Road, Corbridge, Northumberland, UK. 11. Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK. 12. PPI Representative, formerly of Grampian University Hospital Trust, Biomedical Physics and Bioengineering, Foresterhill, Aberdeen, UK. 13. Department of Urology, Newcastle upon Tyne NHS Hospital Trust, Newcastle Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, UK.
Abstract
BACKGROUND: Invasive urodynamics is used to investigate the causes of lower urinary tract symptoms; a procedure usually conducted in secondary care by specialist practitioners. No study has yet investigated the feasibility of carrying out this procedure in a non-specialist setting. Therefore, the aim of this study was to explore, using qualitative methodology, the feasibility and acceptability of conducting invasive urodynamic testing in primary care. METHODS: Semi-structured interviews were conducted during the pilot phase of the PriMUS study, in which men experiencing bothersome lower urinary tract symptoms underwent invasive urodynamic testing along with a series of simple index tests in a primary care setting. Interviewees were 25 patients invited to take part in the PriMUS study and 18 healthcare professionals involved in study delivery. Interviews were audio-recorded, transcribed verbatim and analysed using a framework approach. RESULTS: Patients generally found the urodynamic procedure acceptable and valued the primary care setting due to its increased accessibility and familiarity. Despite some logistical issues, facilitating invasive urodynamic testing in primary care was also a positive experience for urodynamic nurses. Initial issues with general practitioners receiving and utilising the results of urodynamic testing may have limited the potential benefit to some patients. Effective approaches to study recruitment included emphasising the benefits of the urodynamic test and maintaining contact with potential participants by telephone. Patients' relationship with their general practitioner was an important influence on study participation. CONCLUSIONS: Conducting invasive urodynamics in primary care is feasible and acceptable and has the potential to benefit patients. Facilitating study procedures in a familiar primary care setting can impact positively on research recruitment. However, it is vital that there is a support network for urodynamic nurses and expertise available to help interpret urodynamic results.
BACKGROUND: Invasive urodynamics is used to investigate the causes of lower urinary tract symptoms; a procedure usually conducted in secondary care by specialist practitioners. No study has yet investigated the feasibility of carrying out this procedure in a non-specialist setting. Therefore, the aim of this study was to explore, using qualitative methodology, the feasibility and acceptability of conducting invasive urodynamic testing in primary care. METHODS: Semi-structured interviews were conducted during the pilot phase of the PriMUS study, in which men experiencing bothersome lower urinary tract symptoms underwent invasive urodynamic testing along with a series of simple index tests in a primary care setting. Interviewees were 25 patients invited to take part in the PriMUS study and 18 healthcare professionals involved in study delivery. Interviews were audio-recorded, transcribed verbatim and analysed using a framework approach. RESULTS:Patients generally found the urodynamic procedure acceptable and valued the primary care setting due to its increased accessibility and familiarity. Despite some logistical issues, facilitating invasive urodynamic testing in primary care was also a positive experience for urodynamic nurses. Initial issues with general practitioners receiving and utilising the results of urodynamic testing may have limited the potential benefit to some patients. Effective approaches to study recruitment included emphasising the benefits of the urodynamic test and maintaining contact with potential participants by telephone. Patients' relationship with their general practitioner was an important influence on study participation. CONCLUSIONS: Conducting invasive urodynamics in primary care is feasible and acceptable and has the potential to benefit patients. Facilitating study procedures in a familiar primary care setting can impact positively on research recruitment. However, it is vital that there is a support network for urodynamic nurses and expertise available to help interpret urodynamic results.
Authors: Anne M Suskind; J Quentin Clemens; Samuel R Kaufman; John T Stoffel; Ann Oldendorf; Bahaa S Malaeb; Teresa Jandron; Anne P Cameron Journal: Urology Date: 2015-03 Impact factor: 2.649
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Authors: Bethan Pell; Emma Thomas-Jones; Alison Bray; Ridhi Agarwal; Haroon Ahmed; A Joy Allen; Samantha Clarke; Jonathan J Deeks; Marcus Drake; Michael Drinnan; Calie Dyer; Kerenza Hood; Natalie Joseph-Williams; Lucy Marsh; Sarah Milosevic; Robert Pickard; Tom Schatzberger; Yemisi Takwoingi; Chris Harding; Adrian Edwards Journal: BMJ Open Date: 2020-06-30 Impact factor: 2.692
Authors: Lucy E Selman; Cynthia A Ochieng; Amanda L Lewis; Marcus J Drake; Jeremy Horwood Journal: Neurourol Urodyn Date: 2018-10-12 Impact factor: 2.696