Evidence map›Paper›PMID 30623216›Full record

ArticleDer Urologe. Ausg. A2019

[Barriers to guideline adherence : Identification of barriers to guideline adherence using a survey on the AWMF S3 guideline epidemiology, diagnosis, treatment, and management of uncomplicated bacterial, community-acquired urinary tract infections in adult patients].

J Kranz, D Schlager, S Mühlstädt, J Nagler, F M E Wagenlehner, L Schneidewind

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Article in Der Urologe. Ausg. A, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
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  7. Article
  8. Uncomplicated urinary tract infections.Deutsches Arzteblatt international · 2011
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

J KranzSt.-Antonius-Hospital Eschweiler, Klinik für Urologie und Kinderurologie, Akademisches Lehrkrankenhaus, RWTH Aachen, Eschweiler, Deutschland.
D SchlagerKlinik für Urologie, Universitätsklinikum Freiburg, Freiburg (Brsg.), Deutschland.
S MühlstädtUniversitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland.
J NaglerSt.-Antonius-Hospital Eschweiler, Klinik für Urologie und Kinderurologie, Akademisches Lehrkrankenhaus, RWTH Aachen, Eschweiler, Deutschland.
F M E WagenlehnerKlinik für Urologie, Kinderurologie und Andrologie, Universitätsklinikum Giessen, Giessen, Deutschland.
L SchneidewindKlinik für Innere Medizin C - Hämatologie/Onkologie/Transplantationszentrum, Universitätsmedizin Greifswald, Ferdinand-Sauerbruchstraße, 17489, Greifswald, Deutschland. laila.schneidewind@uni-greifswald.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSeveral studies have shown that nonadherence to guidelines is pretty common in the treatment of urinary tract infections (UTI). However, no urological study has raised the question, what are barriers or reasons for this nonadherence, yet.

objectivesConsequently, we performed a survey among German urologists with the primary endpoint identification of barriers for nonadherence to German guidelines on UTI. MATERIALS AND

methodsA 19-item questionnaire was developed and transferred to the online portal "Survey Monkey®" (Private Equity, San Mateo, CA, USA) and tested for usability by our study group. The link for the survey was sent twice to the members of the German Society of Urology (DGU).

resultsOverall, 307 questionnaires were completed. The mean age of the study population was 46.7 years (standard deviation 11.5). The majority (34.9%) followed guidelines in 80% of the cases. Main reasons for nonadherence on the physicians' side were 23.4% personal experience and lacking practicality of UTI guidelines on the individual complex patient. On the open questions urologists mostly stated (11.7%) that the main reason on the physician side for nonadherence is ignorance. Therefore they, in open questions, suggest to promote guidelines more in meetings and more designed practically with shortcuts and simple layout. Patient-associated factors mentioned were mostly in 26.7%. Furthermore, German urologists stated that guidelines should also have a patient section, where the main recommendations are explained in plain language.

conclusionWe performed the first survey on identifying barriers for nonadherence to guidelines in urology. Despite some limitations, our results are very important for the further design of guidelines. This has the potential to improve guideline adherence.

Indexed as

Guideline AdherencePractice Guidelines as TopicAdultBacterial InfectionsBacteriuriaCommunity-Acquired InfectionsEvidence-Based MedicineGermanyHumansPhysiciansPractice Patterns, Physicians'Secondary PreventionSurveys and QuestionnairesUrinary Tract InfectionsUrologyAntibiotic stewardshipDevelopment of guidelinesGuideline adherencePatient informationUrinary tract infection

Identifiers

PMID30623216

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.