Identifying and addressing UTI prevention barriers in primary care: a qualitative study

Background Urinary tract infection (UTI) recurrence rates are high for certain patient groups, affecting physical and mental health, and leading to repeated antibiotic usage. Behavioural measures and non-antibiotic products can prevent recurrences, reducing the need for antibiotics. However, these preventive strategies are often not addressed, despite being advocated in UTI guidelines.

Aim To identify barriers to and facilitators of discussing UTI prevention in primary care and to identify strategies to overcome these barriers.

Design & setting Qualitative study in primary care setting.

Method Semi-structured interviews were performed with general practitioners, doctor’s assistants, and patients with a history of UTI to identify barriers to and facilitators of discussing UTI prevention. Deductive content analysis was employed, using the Theoretical Domains Framework to structure the interview guide and analyse the data. Subsequent focus groups were performed to identify strategies to overcome the barriers.

Results Main barriers for all stakeholders included incomplete knowledge, prioritization of treatment over prevention, and time pressure at the general practice. Additionally, general practices lacked protocols on when, which, and by whom preventive measures should be discussed. Healthcare professionals also assumed patients already held preventive knowledge and solely sought care to obtain antibiotics. The main facilitator was patient-initiated conversations about UTI. Strategies included enhancing knowledge, inviting patients to initiate conversations about UTI, and optimizing the timing of preventive information dissemination.

Conclusion Barriers exist across behavioural, interpersonal, and organizational domains, but provide clear starting points for tailored interventions. The strategies offer promising directions for improving UTI prevention and reducing antimicrobial consumption.