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The relationship between treatment objectives and practice patterns in the management of urinary tract infections
Stephen D Flach1, J Craig Longenecker, Thomas G Tape
1Section of General Internal Medicine, Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, USA. Stephen-flach@uiowa.edu
Objective:
To describe physicians' goals when treating uncomplicated urinary tract infections (UTIs) and the relationship between goals and practice patterns.
Study Design:
Analysis of survey results.
Population:
Primary care physicians.
Outcomes Measured:
Self-reported treatment objectives and practice patterns.
Results:
Most physicians reported their UTI management was convenient for the patient (81.3%). Fewer stated they minimized patients' costs (53.4%), made an accurate diagnosis (56.7%), or avoided unnecessary antibiotics (40.9%). Physicians who stressed convenience or minimizing patient expenses were less likely to use many resources (urine culture, microscopic urinalysis, followup visits and tests, and prolonged antibiotic treatment) and more likely to use telephone treatment. Physicians who stressed accurate diagnoses or avoiding unnecessary antibiotics were more likely to use the same resources and less likely to use telephone treatment.
Conclusion:
UTI management goals vary across physicians and are associated with different clinical approaches. Differences in treatment objectives may help explain variations in practice patterns.