GPs’ Perspective on a Multimodal Intervention to Enhance Guideline-Adherence in Uncomplicated Urinary Tract Infections: A Qualitative Process Evaluation of the Multicentric RedAres Cluster-Randomised Controlled Trial
Angela Schuster,
Paula Tigges,
Julianna Grune,
Judith Kraft,
Alexandra Greser,
Ildikó Gágyor,
Mandy Boehme,
Tim Eckmanns,
Anja Klingeberg,
Andy Maun,
Anja Menzel,
Guido Schmiemann,
Christoph Heintze,
Jutta Bleidorn
Affiliations
Angela Schuster
Institute of General Practice, Charite University Hospital Berlin, 10117 Berlin, Germany
Paula Tigges
Institute of General Practice, Charite University Hospital Berlin, 10117 Berlin, Germany
Julianna Grune
Institute of General Practice, Charite University Hospital Berlin, 10117 Berlin, Germany
Judith Kraft
Institute of General Practice, Charite University Hospital Berlin, 10117 Berlin, Germany
Alexandra Greser
Department of General Practice, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
Ildikó Gágyor
Department of General Practice, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
Mandy Boehme
Institute of General Practice, University Hospital Jena, 07743 Jena, Germany
Tim Eckmanns
Robert Koch Institute, 13353 Berlin, Germany
Anja Klingeberg
Robert Koch Institute, 13353 Berlin, Germany
Andy Maun
Institute of General Practice/Primary Care, Faculty of Medicine and Medical Center, University of Freiburg, 79110 Freiburg im Breisgau, Germany
Anja Menzel
Institute of General Practice/Primary Care, Faculty of Medicine and Medical Center, University of Freiburg, 79110 Freiburg im Breisgau, Germany
Guido Schmiemann
Department of Health Service Research, Institute for Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
Christoph Heintze
Institute of General Practice, Charite University Hospital Berlin, 10117 Berlin, Germany
Jutta Bleidorn
Institute of General Practice, University Hospital Jena, 07743 Jena, Germany
Urinary tract infections (UTIs) are among the most common reasons patients seeking health care and antibiotics to be prescribed in primary care. However, general practitioners’ (GPs) guideline adherence is low. The RedAres randomised controlled trial aims to increase guideline adherence by implementing a multimodal intervention consisting of four elements: information on current UTI guidelines (1) and regional resistance data (2); feedback regarding prescribing behaviour (3); and benchmarking compared to peers (4). The RedAres process evaluation assesses GPs’ perception of the multimodal intervention and the potential for implementation into routine care. We carried out 19 semi-structured interviews with GPs (intervention arm). All interviews were carried out online and audio recorded. For transcription and analysis, Mayring’s qualitative content analysis was used. Overall, GPs considered the interventions helpful for knowledge gain and confirmation when prescribing. Information material and resistance were used for patient communication and teaching purposes. Feedback was considered to enhance reflection by breaking routines of clinical workup. Implementation into routine practice could be enhanced by integrating feedback loops into patient management systems and conveying targeted information via trusted channels or institutions. The process evaluation of RedAres intervention was considered beneficial by GPs. It confirms the convenience of multimodal interventions to enhance guideline adherence.