TY - JOUR T1 - Challenges in managing urinary tract infection and the potential of a point-of-care test guided care in primary care: an international qualitative study JF - BJGP Open JO - BJGP Open DO - 10.3399/bjgpopen18X101630 VL - 3 IS - 2 SP - bjgpopen18X101630 AU - Lucy Brookes-Howell AU - Emma Thomas-Jones AU - Janine Bates AU - Marie-Jet Bekkers AU - Curt Brugman AU - Elinor Coulman AU - Nick Francis AU - Khurram Hashmi AU - Kerenza Hood AU - Nigel Kirby AU - Carl Llor AU - Paul Little AU - Michael Moore AU - Anna Moragas AU - Kate Rumsby AU - Theo Verheij AU - Christopher Butler Y1 - 2019/07/01 UR - http://bjgpopen.org/content/3/2/bjgpopen18X101630.abstract N2 - Background Little is known about clinicians’ experiences of using a point-of-care test (POCT) to inform management of urinary tract infection (UTI) in general practice.Aim To 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 & setting Telephone 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.Method Thematic analysis of semi-structured interviews.Results Most 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.Conclusion Primary care clinicians believe that POCT tests could play a useful role in the management of UTI and gave clear recommendations for successful implementation. ER -