Evidence map›Paper›PMID 31366667›Full record

ArticleBJGP open2019

Challenges in managing urinary tract infection and the potential of a point-of-care test guided care in primary care: an international qualitative study.

Lucy Brookes-Howell, Emma Thomas-Jones, Janine Bates, Marie-Jet Bekkers, Curt Brugman, Elinor Coulman, Nick Francis, Khurram Hashmi, Kerenza Hood, Nigel Kirby and 7 more

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In one paragraph

Article in BJGP open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing 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

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

  1. Primary care practitioners' experiences managing urinary tract infections: a qualitative evidence synthesis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
  6. Article
  7. 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

17 authors.

Lucy Brookes-HowellResearch Fellow (Qualitative), Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Emma Thomas-JonesResearch Fellow, Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK thomas-jonese@cardiff.ac.uk.
Janine BatesResearch Associate, Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Marie-Jet BekkersResearch Associate, Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Curt BrugmanProject Manager, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands.
Elinor CoulmanResearch Associate, Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Nick FrancisProfessor, Division of Population Medicine, Cardiff University, Cardiff, UK.
Khurram HashmiGP Academic Fellow, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.
Kerenza HoodProfessor, Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Nigel KirbySenior Data Manager, Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Carl LlorGP and Researcher, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.
Paul LittleProfessor, Primary Care & Population Sciences, University of Southampton, Southampton, UK.
Michael MooreProfessor, Primary Care & Population Sciences, University of Southampton, Southampton, UK.
Anna MoragasProject Manager, University Institute in Primary Care Research Jordi Gol, Via Roma Health Centre, Barcelona, Spain.
Kate RumsbyStudy Manager, Primary Care & Population Sciences, University of Southampton, Southampton, UK.
Theo VerheijProfessor, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands.
Christopher ButlerProfessor of Primary Care, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLittle is known about clinicians' experiences of using a point-of-care test (POCT) to inform management of urinary tract infection (UTI) in general practice.

aimTo explore experiences of using the Flexicult test to inform management of UTI and views on requirements for an optimal POCT to inform successful implementation. DESIGN &

settingTelephone interviews with 35 primary care clinicians and healthcare professionals in Wales, England, Spain, and the Netherlands, who had participated in a trial of the Flexicult POCT for UTI based on urine culture.

methodThematic analysis of semi-structured interviews.

resultsMost primary care clinicians interviewed agreed on the need for a POCT in UTI management, and that the Flexicult POCT delivered quicker results than laboratory results used in usual care, reassured patients, boosted their confidence in decision-making, and reminded them about antibiotic stewardship. However, clinicians also reported difficulties in interpreting results, limitations on when the Flexicult could be used, and concerns that testing all patients would strain care delivery and prolong patient discomfort when delaying decisions until a non-rapid POCT result was available. An optimal POCT would produce more rapid results, and be reliable and easy to use. Uptake into routine care would be enhanced by: clear guidance on which patients should be tested; training for interpreting 'grey area' results; reiterating that even 'straightforward' cases might be better managed with a test; clear messages about stopping unnecessary antibiotics versus completing a course; and better self-management strategies to accompany implementation of delayed, or non-prescription of, antibiotics.

conclusionPrimary care clinicians believe that POCT tests could play a useful role in the management of UTI and gave clear recommendations for successful implementation.

Indexed as

antibioticsdiagnosisgeneral practicepoint-of-care testingqualitative researchurinary tract infections

Identifiers

PMID31366667
PMCPMC6662873

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.