RT Journal Article
SR Electronic
T1 Development of quality indicators for the diagnosis and treatment of urinary tract infections in general practice: a RAND appropriateness method
JF BMJ Open Quality
JO BMJ Open Qual
FD British Medical Journal Publishing Group
SP e002156
DO 10.1136/bmjoq-2022-002156
VO 12
IS 2
A1 Saust, Laura Trolle
A1 Siersma, Volkert Dirk
A1 Bjerrum, Lars
A1 Hansen, Malene Plejdrup
YR 2023
UL http://bmjopenquality.bmj.com/content/12/2/e002156.abstract
AB Objective To develop a set of quality indicators for the diagnosis and antibiotic treatment of adult patients with suspected urinary tract infections in general practice.Design A Research and Development/University of California Los Angeles appropriateness method was used.Setting Danish general practice.Subjects A 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 measures The 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.Results A 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.Conclusion This 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.All data relevant to the study are included in the article or uploaded as online supplemental information.