Management of lower urinary tract infection in women by Slovene GPs
Management of lower urinary tract infection in women by Slovene GPs
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DOI：
10.1093/fampra/cmg421
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发表时间：
2003-08-01
期刊：
影响因子：
2.2
通讯作者：
Vegnuti, M
中科院分区：
文献类型：
--
作者：
Car, J;Svab, I;Vegnuti, M
背景单纯性下尿路感染（LUTI）是全科治疗中最常见的感染之一。虽然全国范围内的LUTI治疗指南越来越多，但大多数欧洲国家，包括斯洛文尼亚，尚未制定这样的指南。我们的目的是描述斯洛文尼亚全科医生的管理简单的LUTI和分析医生和手术的特点，影响这种管理。向斯洛文尼亚GP的代表性样本发送了一份书面病例简介，并附有关于医生决定的开放式问题（即，要求进行的检查和实验室检查、治疗方案、病假建议、治疗建议和随访程序）以及关于医生和手术特征的问题。应答率为129/171（75.4%）。LUTI的管理有很大的差异：17.8%的全科医生要求进行各种额外的实验室检查; 57%的全科医生处方甲氧苄啶/磺胺甲恶唑和37%诺氟沙星; 30%的全科医生处方药物10-14天; 53.5%的全科医生让患者休病假1-10天。工作量大的医生和等待化验结果时间>24 h的医生要求更多的额外检查。需要制定有效的质量改进战略以及实践指南。更重的工作量对LUTI管理的影响和实验室检查的可及性的影响，应在未来的研究中进行探讨。
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.