Development of quality indicators for the diagnosis and treatment of urinary tract infections in general practice: a RAND appropriateness method
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Published:2023-05
Issue:2
Volume:12
Page:e002156
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ISSN:2399-6641
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Container-title:BMJ Open Quality
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language:en
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Short-container-title:BMJ Open Qual
Author:
Saust Laura TrolleORCID,
Siersma Volkert Dirk,
Bjerrum Lars,
Hansen Malene Plejdrup
Abstract
ObjectiveTo develop a set of quality indicators for the diagnosis and antibiotic treatment of adult patients with suspected urinary tract infections in general practice.DesignA Research and Development/University of California Los Angeles appropriateness method was used.SettingDanish general practice.SubjectsA panel of nine experts, mainly general practitioners, was asked to rate the relevance of 27 preliminary quality indicators. The set of indicators was based on the most recent Danish guidelines for the management of patients with suspected urinary tract infection. An online meeting was held to resolve misinterpretations and achieve consensus.Main outcome measuresThe experts were asked to rate the indicators on a nine-point Likert scale. Consensus of appropriateness was reached if the overall panel median rating was 7–9 with agreement. Agreement was defined as: no more than one expert rated the indicator outside the three-point region (1–3, 4–6 and 7–9) containing the median.ResultsA total of 23 of the 27 proposed quality indicators attained consensus. One additional indicator was proposed by the panel of experts, leading to a final set of 24 quality indicators. All indicators focusing on the diagnostic process achieved consensus of appropriateness, while the experts agreed on three quarters of the proposed quality indicators concerning either the treatment decision or the choice of antibiotics.ConclusionThis set of quality indicators may be used to strengthen general practice’s focus on the management of patients with a possible urinary tract infection and to identify potential quality problems.
Funder
the Section of General Practice, Department of Public Health, University of Copenhagen, Denmark
Kvalitets- og efteruddannelsesudvalget (KEU) in the Capital Region of Denmark
Subject
Public Health, Environmental and Occupational Health,Health Policy,Leadership and Management
Reference39 articles.
1. The WHO policy package to combat antimicrobial resistance
2. Danmap . Use of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from food animals, food and humans in Denmark. 2020. Available: www.danmap.org
3. European Centre for Disease Prevention and Control . Antimicrobial consumption in the EU/EEA – annual epidemiological report 2019. 2020. Available: https://www.ecdc.europa.eu/en/publications-data/surveillance-antimicrobial-consumption-europe-2019
4. Prescription of antibiotics for urinary tract infection in general practice in Denmark
5. Marshall M , Campbell S , Hacker J , et al . Quality Indicators for general practice: a practical guide for health professionals and managers. London: Royal Society of Medicine Press Limited, 2002: 1–186.