Improved management of cystitis in primary care following the implementation of a simple multifaceted intervention
Copyright © 2022 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved..
OBJECTIVE: We assessed the impact of the implementation of a simple multifaceted intervention aimed at improving management of cystitis in primary care.
DESIGN: Quality control before and after study. SITE: Primary care centres in Barcelona city provided by the Catalonian Institute of Health.
PARTICIPANTS: The multifaceted intervention consisted of (1) creation of a group with a leader in each of the primary care centres, out of hours services, sexual and reproductive centres, and home visit service, (2) session on management of cystitis in each centre, (3) result feedback for professionals, and (4) provision of infographics for professionals and patients with urinary tract infections. Interventions started in November 2020 and ended in the summer of 2021.
MAIN MEASUREMENTS: Variation in the prescription of first-line antibiotics, usage of antibiotics, and request for urine cultures before and after this intervention.
RESULTS: Training sessions took place in 93% of the centres. The use of first-line therapies cystitis increased by 6.4% after the intervention (95% confidence interval [CI], 5.7-7.1%). The use of nitrofurantoin in recurrent cystitis increased, mainly in out of hours service (8.7%; 95% CI, 5.2-12.2%). Urine cultures were more frequently requested after the intervention for recurrent cystitis in both primary care centres and out of hours services, with a 7.2% increase [95% CI, 5.9-8.5%), but also for uncomplicated urinary tract infections (3.1%; 95% CI, 1.8-4.4%).
CONCLUSIONS: A low-intensity multifaceted intervention on management of cystitis, with strong institutional support, resulted in a better choice of antibiotic in antibiotic prescribing, but the intervention had less impact on the adequacy of urine cultures.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:54 |
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| Enthalten in: |
Atencion primaria - 54(2022), 11 vom: 11. Nov., Seite 102493 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gallardo, Sara [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 21.11.2022 Date Revised 05.12.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.aprim.2022.102493 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Gallardo, Sara |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Improved management of cystitis in primary care following the implementation of a simple multifaceted intervention |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Revised 05.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a OBJECTIVE: We assessed the impact of the implementation of a simple multifaceted intervention aimed at improving management of cystitis in primary care | ||
| 520 | |a DESIGN: Quality control before and after study. SITE: Primary care centres in Barcelona city provided by the Catalonian Institute of Health | ||
| 520 | |a PARTICIPANTS: The multifaceted intervention consisted of (1) creation of a group with a leader in each of the primary care centres, out of hours services, sexual and reproductive centres, and home visit service, (2) session on management of cystitis in each centre, (3) result feedback for professionals, and (4) provision of infographics for professionals and patients with urinary tract infections. Interventions started in November 2020 and ended in the summer of 2021 | ||
| 520 | |a MAIN MEASUREMENTS: Variation in the prescription of first-line antibiotics, usage of antibiotics, and request for urine cultures before and after this intervention | ||
| 520 | |a RESULTS: Training sessions took place in 93% of the centres. The use of first-line therapies cystitis increased by 6.4% after the intervention (95% confidence interval [CI], 5.7-7.1%). The use of nitrofurantoin in recurrent cystitis increased, mainly in out of hours service (8.7%; 95% CI, 5.2-12.2%). Urine cultures were more frequently requested after the intervention for recurrent cystitis in both primary care centres and out of hours services, with a 7.2% increase [95% CI, 5.9-8.5%), but also for uncomplicated urinary tract infections (3.1%; 95% CI, 1.8-4.4%) | ||
| 520 | |a CONCLUSIONS: A low-intensity multifaceted intervention on management of cystitis, with strong institutional support, resulted in a better choice of antibiotic in antibiotic prescribing, but the intervention had less impact on the adequacy of urine cultures | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antibacterial agents | |
| 650 | 4 | |a Antibióticos | |
| 650 | 4 | |a Antimicrobial stewardship | |
| 650 | 4 | |a Atención primaria | |
| 650 | 4 | |a Infecciones del tracto urinario | |
| 650 | 4 | |a Primary health care | |
| 650 | 4 | |a Programas de optimización de antibióticos | |
| 650 | 4 | |a Urinary tract infections | |
| 650 | 4 | |a Urine culture | |
| 650 | 4 | |a Urocultivo | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Troncoso-Mariño, Amelia |e verfasserin |4 aut | |
| 700 | 1 | |a Nadal-Braqué, Núria |e verfasserin |4 aut | |
| 700 | 1 | |a Amado-Guirado, Esther |e verfasserin |4 aut | |
| 700 | 1 | |a Mallecot, Yannick Hoyos |e verfasserin |4 aut | |
| 700 | 1 | |a Llor, Carl |e verfasserin |4 aut | |
| 700 | 0 | |a PROA-ICS Barcelona Study Group |e verfasserin |4 aut | |
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